Forearm Nonunion: Characterization and Management.

J Hand Surg Am · Nov 2020 · Review

Srinivasan RC, Hutson RL, Richard MJ

Hand Center of San Antonio, Department of Orthopedic Surgery, University of Texas Health San Antonio, TX

Hand & Upper Extremity Orthopaedic Trauma

SUMMARY — THE REDUCTIONReviews adult forearm nonunion evaluation and management, stressing biology and stability optimization and covering workup plus surgical options from debridement and revision fixation to autograft, allograft, and vascularized fibula.
Abstract, as published

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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