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Forearm Nonunion: Characterization and Management
Ramesh C Srinivasan1, Russell L Hutson1, Marc J Richard2
1Hand Center of San Antonio, Department of Orthopedic Surgery, University of Texas Health San Antonio, San Antonio, TX.
Abstract:
Adult forearm nonunion should be investigated prior to developing a treatment strategy: "Why did the fracture not heal?" Optimizing the patient's biology and the stability at the nonunion site are critical for a successful outcome. This review concisely discusses the initial work-up, including history, physical examination, imaging, and laboratory testing, as well as available surgical techniques-irrigation and debridement with deep cultures, revision open reduction internal fixation with or without biological adjuvant therapies, cancellous autograft, tricortical iliac crest, reamer/irrigator/aspirator, allograft, vascularized free-fibula and induced-membrane technique.
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