title: Treatment of nonunion of the forearm bones with posterior interosseous bone flap.
abstract: BACKGROUND
  Reconstructions of forearm fracture nonunions are frequently complex. A few studies that help guide the treatment of forearm nonunion have been reported. We offer a novel surgical technique to treat nonunion of the forearm using a regional vascularized bone graft.
  
  
  METHODS
  Four females and 5 males ranging from 27 to 74 years of age with 7 ulna and 2 radius nonunions were surgically treated by pedicle grafting with a posterior interosseous bone flap (PIBF) and internal fixation with a plate. There were no cases with extensive soft tissue damage or infection. Pre- and postoperatively (mean 21 months), all patients were assessed by radiographs and for function by the Disabilities of the Arm, Shoulder and Hand (DASH) score.
  
  
  RESULTS
  Function of the upper extremity was improved in all patients. DASH scores improved from 61.2 points pre-operatively to 12 points at final follow-up. All nonunions were united uneventfully.
  
  
  CONCLUSIONS
  Following debridement of the necrotic tissue, the bone defect can be filled with a vascularized graft from posterior interosseous pedicles. Pedicled PIBF is a safe and useful novel technique in cases of atrophic or hypertrophic nonunion of the middle third of the radius or proximal two-thirds of the ulna.
authors.affiliation: Department of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Kargar Shomali Street, Tehran, Iran. rz_kamrani@yahoo.com
authors.forename: Reza Shahryar
authors.initials: RS
authors.lastname: Kamrani
authors.forename: Saeed Reza
authors.initials: SR
authors.lastname: Mehrpour
authors.forename: Reza
authors.initials: R
authors.lastname: Sorbi
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Aghamirsalim
authors.forename: Leila
authors.initials: L
authors.lastname: Farhadi
mesh_terms: D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005599:Fractures, Ununited / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000601:surgery*; D013524:Surgical Flaps; D014458:Ulna Fractures / Q000601:surgery*