Evaluation of outcomes in aseptic non-unions of the forearm bones in adults treated with LCP and autograft.

BACKGROUND: The aim of the present study was to evaluate the effect of locking compression plate (LCP) and autografting application in patients with nonunion of forearm fractures on radiologic and clinical outcome.

METHODS: A total of 26 patients (16 males, 10 females; mean age: 45.7 years) with nonunion after surgical treatment of forearm fractures were included. Nonunion was located in the ulna in 14 patients, in the radius in 5 patients, and in both in 7 patients (21 ulna, 12 radius).Infection markers were checked prior to surgery. Samples for microbiologic cultures were peroperatively obtained in 7 patients with a history of open fractures. Autografting from the iliac crest and 3.5-mm LCP were applied. Type of nonunion, time to unification, range of motion in the wrist and elbow joints, and complications were analyzed. Functional evaluation was performedusing the scoring system described by Anderson et al.

RESULTS: Mean follow-up period was 49.3 months (range 24-73 months). Unification was achieved in a mean 5.7 months (range 3-14 months). Additional surgical process was not required. No bacterial proliferation was observed in cultures. Superficial infection was observed in 3 patients and deep infection in 1. Results were scored as excellent in 10 (38.4%) patients, satisfactory in 13 (50%), and unsatisfactory in 3 (11.6%).

CONCLUSION: Treatment of aseptic forearm nonunion in adults with autografting from the iliac crest and 3.5-mmLCP fixation increases unification rate and aids in function recovery.