Treatment of Distal Radius Fracture Nonunion With Posterior Interosseous Bone Flap
Hossein Saremi1, Reza Shahryar-Kamrani2, Bahareh Ghane3
1Department of Orthopaedic and Trauma Surgery, Besat Hospital, Hamadan University of Medical Sciences, Hamadan, IR Iran.
Background:
Nonunion of distal radius fractures is disabling. Treatment is difficult and the results are not predictable. However, posterior interosseous bone flap (PIBF) has been successful in treating forearm nonunion.
Objectives:
To treat distal radius fracture nonunion with PIBF as a new procedure.
Patients And Methods:
This prospective non-randomized cohort study was performed at two hospitals in Tehran between January 2011 and September 2015. PIBFs were applied in nine patients (10 nonunions) with a mean age of 55 years. Union success rate, grip strength, wrist range of motion, and forearm rotation were then evaluated.
Results:
Although four of the patients had a history of infection, all participants achieved fracture union at a mean time of 3.8 months. Grip strength improved by 12.4 kg. There was also 36° improvement in wrist flexion, 20° improvement in wrist extension, 60° improvement in forearm supination, and 46° improvement in forearm pronation. The range of motion and grip strength improvements were significant.
Conclusions:
Pedicled PIBF is a new option for treating distal radius fracture nonunion. The results are predictable in achieving union and good function, and this technique can be successfully used in cases with extensive soft-tissue damage or infection.
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