[Treatment of aseptic ulnar non-union in a patient with spastic hemiparesis by Ilizarov method]

Both-bone diaphyseal forearm fractures in children are common lesions. Non-union is very rare, almost exclusively in the ulna. We present a case of forearm fracture in a patient with spastic hemiparesis involving the injured forearm, treated initially with open reduction and intramedullary nailing. Ulnar deviation of both bones, with bending of intramedullary implants, occurred during postoperative period, due to spasticity of forearm flexors. An aseptic non-union of the ulna also developed. Both complications were treated by compression osteogenesis using a Ilizarov circular frame, the end results being excellent. The unusual and rare association between a preexisting neurologic spastic disorder and a forearm fracture can lead to malunion or/and nonunion, a more rigid method of initial osteosynthesis (locked compression plate) being an alternative in such cases.