Infected forearm nonunion treated by bone transport after debridement.
BACKGROUND
This is a therapeutic study to evaluate the results of the management of forearm infected nonunion using bone transport with external fixators after debridement.


METHODS
We have retrospectively reviewed a consecutive series of 21 patients from October 1994 to June 2010 in our institution who were treated for the forearm infected nonunion by bone transport with external fixator after debridement. There were 12 males and 9 females. The mean age of the patients was 27.1 years. Of the initial fractures, nonunion of the radius alone invovled in 7 patients, nonunion of the ulna alone invovled in 12, and nonunion of the radius and ulna invovled in 2. Nineteen limbs (85.7%) were in active infected state with sinus and drainage. The mean amount of bone defect was 3.1 cm (range 1.8-4.6 cm) as measured on plain radiographs.


RESULTS
The mean follow-up was 77.5 months. All patients achieved bony union and were satisfied with the functional and cosmetic outcome. All the infection had been controlled. The mean external fixation index was 42.5 day/cm. The average time for wound healing was 42 days. The mean length gained was 3.5 cm (2.1-5.3 cm).


CONCLUSIONS
The technique of bone transport after debridement is a safe, effective, and minimally invasive treatment for forearm infected nonunion.
Department of Orthopaedics, the Second Xiangya Hospital, Cental South University, Changsha, 410011 Hunan, PR China. dr.lynnling@gmail.com.
Tang
T
Liu
Zhenyang
Z
Liu
Lin
L
Ling
Xiangsheng
X
Zhang
D000293:Adolescent; D000328:Adult; D001850:Bone Diseases, Infectious / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D001858:Bone Nails; D003646:Debridement; D016267:External Fixators; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy; D011885:Radius Fractures / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D055815:Young Adult