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Testing Tactile Masking between the Forearms
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One-Bone Forearm Reconstruction: A Salvage Solution for the Forearm with Massive Bone Loss
Agraharam Devendra1, Purnaganapathi Sundaram Velmurugesan1, Jayaramaraju Dheenadhayalan1
1Departments of Orthopaedics (A.D., P.S.V., J.D., and S.R.) and Plastic & Micro Reconstructive Surgery (H.V. and S.R.S.), Ganga Hospital, Coimbatore, India.
The Journal of Bone and Joint Surgery. American Volume
|August 9, 2019
Summary
One-bone forearm (OBF) reconstruction offers a viable alternative to amputation for severe forearm bone loss. This demanding procedure yields better function and cosmetic results compared to forearm amputation.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
- Trauma Surgery
Background:
- Massive forearm bone loss presents significant salvage challenges.
- Reconstruction is critical after severe trauma or oncological resection.
- One-bone forearm (OBF) reconstruction is explored as a limb salvage option.
Purpose of the Study:
- To evaluate the efficacy of one-bone forearm (OBF) reconstruction.
- To assess OBF as a salvage procedure for extensive forearm bone defects.
- To analyze outcomes in patients with acute and chronic forearm bone loss.
Main Methods:
- Retrospective review of 38 patients with forearm segmental bone loss (1995-2014).
- Included acute injuries (replantation/revascularization) and chronic cases (infection, tumor, nonunion).
- Surgical techniques involved OBF conversion, DRUJ fusion, or ulna-to-carpal fusion, with bone grafting or free vascularized fibular grafts.
Main Results:
- Mean age 35.5 years; 38 patients analyzed.
- For acute injuries, mean union time was 7.3 months; 14/16 achieved union.
- Functional outcomes (Chen criteria) and overall results (Peterson scoring) showed predominantly good to excellent results in elective cases.
Conclusions:
- One-bone forearm (OBF) reconstruction is a feasible and effective salvage procedure.
- OBF offers superior functional and cosmetic outcomes compared to forearm amputation.
- This technique provides a valuable alternative for complex forearm reconstructions.
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