Document Detail


Revision of the ununited one-bone forearm.
MedLine Citation:
PMID:  9848564     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Between 1975 and 1995, 7 patients were surgically treated for persistent forearm pain following previously unsuccessful attempts of constructing a radioulnar synostosis using interosseous bone grafting with either cross screw or pin fixation. These prior reconstructive procedures were salvage operations to address symptomatic radioulnar instability. The time interval between index operation and revision surgery was a mean of 12.6 months (range, 4-36 months). The postoperative follow-up period averaged 29.7 months (range, 11-61 months). To address these failed radioulnar arthrodeses, plate osteosynthesis and aggressive bone grafting were used in 5 of 7 patients (group 1) (4 with autologous graft and 1 with demineralized bone matrix). Union was achieved in all 5 patients after a single revision operation. Radiographic evidence of solid union was seen at approximately 4 months. In the remaining 2 patients (group 2), revision synostosis procedures were performed; these involved local bone grafting and repeat transverse screw fixation in 1 patient and iliac crest bone grafting alone in the other. One of these 2 patients progressed to union; the other had a persistent symptomatic fibrous union. The 5 patients in group 1 reported symptomatic relief, while the 2 patients in group 2 were dissatisfied. There were no postoperative complications in our series. Based on our findings, we advocate abundant bone grafting and plating for rigid internal fixation in failed radioulnar synostosis procedures.
Authors:
F Chen; R W Culp; L H Schneider; A L Osterman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  23     ISSN:  0363-5023     ISO Abbreviation:  J Hand Surg Am     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1999-03-09     Completed Date:  1999-03-09     Revised Date:  2009-06-08    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1091-6     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Arthrodesis
Bone Transplantation
Female
Forearm Injuries / complications,  radiography,  surgery
Humans
Internal Fixators
Joint Instability / etiology,  surgery
Male
Middle Aged
Radius / physiopathology,  radiography,  surgery*
Reconstructive Surgical Procedures / methods
Reoperation
Treatment Outcome
Ulna / physiopathology,  radiography,  surgery*
Wound Healing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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