Pseudoartrosi asettiche di avambraccio trattate mediante placca e innesto osseo contrapposto ed intercalare da perone autologo

Objective Forearm nonunion frequently changes the relationship between the radius end ulna and may lead to impairment of forearm function. We propose a new surgical technique for aseptic forearm nonunionscombining a fibular cortical autograft atrut with a metal plate and a fibukar intercalary autograft in cases with a segmental bone defect. Material and Methods We retrospectively reviewed 20 patients with a mean age of 31 years (range, 17-48 years) at the time of surgery, presenting in 2 cases an isolated nonunion of the radius, in 14 cases an isolated nonunione of the ulna and in 4 cases the nonunion of both bones. Nonunions were atrophic in 18 cases and ipertrophic in 6 cases. Minimum follow-up was 12 years (mean, 14 years; range, 12-21 years). Results There were non intraoperative or postoperative complications. At last follow-up, all forearm bones had remolled. The mean visual analog pain scale was 1 (range, 0-3). Forearm function improved; there were no radiographic signs of ankle arthritis at follow-up. Conlusions Surgical treatment of aseptic forearm nonunions by combining a massive fibular cortical autogrft strut with a plate anmd associating a fibular intercalary autograft in caseof a segmental bone defect led to bone healing, improved forearmfunction, and a durable outcome with long-term follow-up.