The management of bone defects of the forearm after trauma.
In summary, the authors believe that traumatic bone defects of the diaphyseal forearm, fewer than 6 cm in length, can be well managed with corticocancellous bone grafting, provided the patient has an adequate soft-tissue envelope. In cases of soft-tissue compromise, primary bone grafting is still the treatment of choice, combined with simultaneous soft-tissue coverage. This does not exclude the use of immediate primary shortening. Traumatic bone defects larger than 6 cm can best be managed with osteoseptocutaneous free fibular graft with excellent functional and cosmetic results. The creation of a one-bone forearm is rarely necessary, but remains a treatment option for an otherwise unsalvageable extremity. Osteo-articular defects can be more difficult to manage. Proximal osteo-articular defects of the radial head can be treated with excision or placement of a titanium radial head prosthesis. Distal osteo-articular defects may be better addressed in the case of radial bone loss by primary wrist fusion and, in the ulna, by a primary Darrach or Suave-Kapandji procedure.
Stevanovic
M
M
Department of Orthopedics, University of Southern California School of Medicine, Los Angeles, USA.
Gutow
A P
AP
Sharpe
F
F
D016025:Bone Transplantation; D001842:Bone and Bones / Q000293:injuries* / Q000601:surgery*; D005543:Forearm Injuries / Q000150:complications* / Q000601:surgery*; D006801:Humans; D011884:Radius / Q000293:injuries / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D017695:Soft Tissue Injuries / Q000601:surgery; D016896:Treatment Outcome; D014457:Ulna / Q000293:injuries / Q000601:surgery