Treatment of non-union of the forearm using distraction-compression osteogenesis.
BACKGROUND
The goal of the study is presentation broad abilities like gives Ilizarov method in the treatment of posttraumatic nonunion the of forearm with concomitant shortening and axis deformity, in minimally invasive technique, with contemporary axis correction and lengthening .


METHODS
. Authors present 6 patient operated on with the use of Ilizarov method, in years 2001-2005 , suffer from vital nonunion of the forearm - 6 cases radius; 1 case ulna and radius. In all cases with nonunion concomitant shortening of the radius from 2 to 3 cm and valgosity of radius with deformity in sagittal plane in 4 patients (2antecurvation, 2 retrocurvation). All patients had restricted rotation ROM of forearm and restriction of wrist motion . Author's modification of Ilizarov apparatus (with mini-Schanz's half-pins, which permitted rotation of forearm) was used in most of patients. In 3 cases monofocal slow correction with lengthening within nonunion was performed. In 2 cases bifocal, one-step slow correction of deformity and compression within nonunion with lengthening was performed. In 1 remaining case compression of ulna nonunion and compression with deformity correction of radius nonunion were performed. Distraction and correction start in 7 postoperative day in rate from 0,25 to 1 mm/day and correspondingly from1 to 2o/day.


RESULTS
Time of correction and distraction was average 63,3 days (40 - 90 days) . Total time of stabilization was average 25,4 weeks (20 - 35 weeks). Bone union was obtained in all patients. In all cases considerable recovery of limb function was achieved. All patients had superficial pin-tract infection . One patient had staphylococcal pin-tract infection of soft tissues, which retreat after 3-weeks guided antibiotic therapy.


CONCLUSIONS
The Ilizarov method permit for contemporary axis correction and/or distraction or compression. There is the method of choice in the treatment of nonunion of forearm with concomitant shortening and axis deformity.
Orzechowski
Wiktor
W
Department of Orthopaedics and Musculoskeletal Traumatology, Medical University in Wrocław, Poland. viktor2000@o2.pl
Morasiewicz
Leszek
L
Dragan
Szymon
S
Krawczyk
Artur
A
Kulej
Mirosław
M
Mazur
Tomasz
T
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005542:Forearm / Q000000981:diagnostic imaging / Q000601:surgery*; D005543:Forearm Injuries / Q000601:surgery*; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D008297:Male; D019857:Osteogenesis, Distraction / Q000379:methods*; D011542:Pseudarthrosis / Q000601:surgery*; D011859:Radiography; D011884:Radius / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D014457:Ulna / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery