Forearm Nonunion: Characterization and Management

J Hand Surg Am. 2020 Nov;45(11):1055-1064. doi: 10.1016/j.jhsa.2020.05.030. Epub 2020 Aug 13.

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.

Keywords: Forearm; nonunion.

Publication types

  • Review

MeSH terms

  • Adult
  • Bone Transplantation
  • Forearm
  • Fractures, Bone*
  • Fractures, Ununited* / diagnostic imaging
  • Fractures, Ununited* / surgery
  • Humans
  • Ilium
  • Transplantation, Autologous