Modified Nicoll’s Graft for Treatment of Gap Non-union of Ulna: A Rare Case Report

INTRODUCTION: Despite the multitude of studies for the treatment of non-unions, no clear criterion has been established for treating a fracture of non-union. Non-union of radius and ulna produces a discrepancy in length which must be restored for adequate rotation and function. Nicoll described a technique of bridging gaps in long bones with solid blocks of cancellous bone and fixing the fragments with metal plates. We utilized modified Nicoll’s graft using corticocancellous graft taken from iliac crest. CASE REPORT: In the present case, a 17-year-old male patient of eastern India presented with gap non-union of 3 cm in ulna of non-dominant hand, left side after 3 years and 6 months of trauma. There was linear surgical scar mark of 8 cm overlying ulna, but there was no sign of infection. He was functionally crippled with severe restriction of range of motion. CONCLUSION: The tricortical cancellous bone graft under optimal compression provides a good solution for the management of gap non-union of both bone forearm for deficit up to 3 cm with no evidence of infection.