Abstract
BackgroundMajor bone defects in forearm caused by severe trauma is a real challenge for orthopedic surgeons. This study aimed to evaluate the role of one-bone forearm (OBF) reconstruction combined with distal radioulnar joint fusion (DRUJF) as a rescue option under this difficult situation. MethodsIn total, 18 patients with major bone defects in forearm caused by severe trauma were selected from 2003 to 2017 and followed up for 2 to 16 years. All patients were managed in the Emergency Department and received emergency one-stage OBF combined with DRUJF. In addition, patient demographics, surgical techniques, clinical outcomes and complications were collected from the medical records. ResultsThe mean age of patients was 41.5 years (ranging from 23 to 58 years), with 11 males and 7 females. The mean time to union was 5.8 months; 17 patients had complete union, and 1 patient had infection with nonunion requiring secondary procedures. According to the criteria of Chen, 3 patients had a grade-I functional outcome, 14 patients had a grade-II functional outcome, and 1 patient had a grade-III functional outcome. Based on the Peterson scoring system, the outcome was excellent for 3 patients, good for 13 patients, fair for 1 patient, and poor for 1 patient. ConclusionOBF reconstruction combined with DRUJF was an alternative surgical procedure as the emergency stage-one intervention for the treatment of traumatic major bone defects in forearm, which may be more functionally and cosmetically superior than forearm amputation.
Highlights
Major bone defects in forearm caused by severe trauma is a real challenge for orthopedic surgeons
one-bone forearm (OBF) construction combined with distal radioulnar joint fusion (DRUJF) was an alternative surgical procedure as the emergency stage-one intervention for the treatment of traumatic major bone defects in forearm, which may be more functionally and cosmetically superior than forearm amputation
Despite advances in microsurgical technology, the treatment of major bone defects in forearm caused by severe trauma remains a real challenge
Summary
Major bone defects in forearm caused by severe trauma is a real challenge for orthopedic surgeons. The length of the ulna and radius is critical to the proper function of the forearm [1] [2]. Despite advances in microsurgical technology, the treatment of major bone defects in forearm caused by severe trauma remains a real challenge. To the best of our knowledge, there are no standard techniques described for reconstruction with major bone loss in the forearm [3]. The loss of composite soft tissue and bone, scar adhesion, and repeated surgical procedures can lead to highly unpredictable functional outcome of this type of injury [4,5,6]
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