Treatment of Nonunion of Forearm Bones Using Radial Forearm Bone Flap

BACKGROUND: Treatment of forearm fracture nonunion is challenging. Several surgical techniques for the treatment of forearm nonunion have been reported. OBJECTIVES: The aim of this prospective study was to evaluate the effects of the radial forearm bone graft technique in cases with forearm nonunion. PATIENTS AND METHODS: We treated 7 patients with forearm nonunions via radial forearm bone flap and internal plate fixation. On the preoperative examination and last follow-up, the quick disabilities of the arm, shoulder, and hand (Q-DASH) score, elbow, forearm and wrist arches of motion and grip force were measured. At the final follow-up, radiographic union and patient satisfaction and return to work were assessed. RESULTS: The mean follow-up duration was 34 ± 23 months. The Q-DASH scores improved from 70 ± 6 points preoperatively to 13 ± 15 points at final follow-up (P < 0.01). The preopetative range of motion (ROM) was 101 ± 26 degrees; whereas the final forearm ROM was 140 ± 17 (P = 0.01). All nonunions united uneventfully (range 3-6 months). At the last follow-up, the grip force was 83% of uninjured extremity and all patients were satisfied with the outcome of the operation. CONCLUSIONS: Radial forearm bone flap is a safe, useful and novel technique in cases with forearm nonunion.