Reconstruction of severely injured forearm bones

Twenty open and severe forearm fractures treated either immediately following crush injury or after primary treatment in other hospitals are reported. Soft tissue coverage required repeated debridement and skin grafting. Internal bone fixation was either delayed, primary or secondary, while tendon and nerve repair was always postponed. Two patients with avascular gangrene required amputation: six were initially placed in a plaster cast (in five there was non-union and in one, malunion); in five intramedullary nailing was used (in two there was non-union); in seven in whom compression plating was used for primary bone fixation and those in whom it was used for treatment of non-union after other methods of fixation, solid union was always obtained.