Abstract
Introduction: Management of non-union with a gap following a fracture of the radius or ulna is a challenging problem. In this study the result of forearm non-union and delayed unions treated using tri-corticocancellous iliac bone graft (Modified Nicoll’s Technique) and newly designed radius-ulna intramedullary nails are evaluated. Materials and Methods: 7 patients with plate-screw osteosynthesis applied because of broken forearm, but non-union developed (5 ulna, 2 radius non-unions) were evaluated. In all cases the length of applied tricortical graft was below 2.5 cm. 4 male and 3 female patients with 37 average age (19–55). All the patients were allowed to mobilize immediately without additional fixation. The results were evaluated according to Grace-Eversmann and DASH scoring. Results: Average follow-up time was 12 months (8–22), healing; 6 months (5–7).Patients were not observed with deep or superficial infection or radioulnar synostosis. According to Grace-Eversmann scoring system excellent and good results were obtained in all cases. Average DASH score was 6 points (5–8). Conclusion: The goal of treatment in non-union is to achieve painless and functioning elbow, forearm and wrist movements. The advantages of Ulna-A and Radius-A nails are compatible with forearm anatomy, to allow the graft placed with full contact where resection applied, to show adequate resistance against axial, rotational and shear forces. This method is that allows immediate post-operative rehabilitation and not requiring additional fixation. The successful results of a limited number of the cases make these nails in the treatment of non-union a promising alternative to standard plate-screw osteosynthesis.
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