Aseptic Diaphyseal Pseudarthrosis of the Forearm Initially Treated with Target Plate: Risk Factors and Management

Abstract

Aseptic diaphyseal pseudarthrosis of the forearm is a major complication. There are patient-related and treatment-related risk factors. The aim of our work is to evaluate the functional and radiological results of aseptic diaphyseal pseudarthrosis of the forearm initially treated with a screw plate. A series of 12 patients were collected in the Orthopedic and Traumatological Surgery Department A of IBN TOFAIL Hospital, retrospectively over a 5-year period. The most frequent site of these pseudarthroses was the ulna (5 cases), followed by both bones (4 cases) and finally the radius (3 cases). 50% of pseudarthroses were atrophic (12 cases). The use of a screw-plate stabilization technique combined with bone grafting and osteo-muscular decortication yielded satisfactory results in terms of bone consolidation and clinical outcome. Smoking is a major risk factor. Solid restraint is necessary to immobilize the fracture site and protect it from forces detrimental to consolidation. De-periostealization and muscular deinsertion are iatrogenic factors that favour the occurrence of pseudarthrosis. Solid DCP plate osteosynthesis combined with autograft after decortication of the fracture site is an important therapeutic weapon with good results.