J Korean Orthop Assoc.  2008 Jun;43(3):322-328. 10.4055/jkoa.2008.43.3.322.

Operative Treatment for Nonunions of Distal Radial Fracture: A Report of 7 Cases

• Kang HJ
• Yoon HK
• Yoon HK
• Han CW
• Jung SH
• Han SB

• KMID: 2186448
• DOI: http://doi.org/10.4055/jkoa.2008.43.3.322

Abstract

PURPOSE: To report the treatment results of 7 cases of distal radius nonunion with a review of the relevant literature.
MATERIALS AND METHODS
Seven patients treated with an autoiliac bone graft and rigid internal fixation for nonunion of the distal radius were analyzed retrospectively for the cause of injury, the factors affecting nonunion, radiological findings, treatment method and complications. The results were analyzed radiologically using Kreder's method and functionally using the Anderson' protocols.
RESULTS
Union was achieved in all cases after a mean period of 19 weeks. The functional result of treatment at the last follow-up was excellent in 4 cases and satisfactory in 3 cases. The probable factors of nonunion were instability of the fracture site in three cases, type II or III open fracture in 2 cases, postoperative infection in one case and idiopathic in one case.
CONCLUSION
Infection control using a stepwise operation, rigid internal fixation and autogenous iliac bone graft showed satisfactory results in distal radius nonunion, which had developed in those with severe open fractures, postoperative infection, instability on the fracture site and associated distal ulnar fracture.

Keyword

Distal radius; Nonunion; Bone graft; Internal fixation

MeSH Terms

Follow-Up Studies
Fractures, Open
Humans
Infection Control
Radius
Retrospective Studies
Transplants

Figure

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  Fig. 1 A line perpendicular to the central long axis of the radius is drawn to the level of the most distal radial articular surface (A), to the level of the ulnar margin of the distal radial articualr surface (B) and to the level of the distal ulnar articular surface (C). RL, radial length; UV, ulnar variance.

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  Fig. 2 (A), (B) Preoperative radiograph of a 23-year-old male patient shows nonunion of a distal radius fracture. (C), (D) Postoperative radiograph taken 14 weeks after surgery shows good union.

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  Fig. 3 (A), (B) Plane radiographs of a 23-year-old male patient taken 8 months after the fracture, which shows nonunion of the fracture and loosening of the implant. (C), (D) Double plating, autoiliac bone graft and resection of the distal ulna were performed. (E) Postoperative CT scan at 12 months after operation shows good union.

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