Reconstruction of skeletal defects in the forearm after trauma: treatment with cement spacer and delayed cancellous bone grafting.

Abstract

Single forearm bone posttraumatic defects averaging 4 cm were successfully reconstructed by first using an antibiotic impregnated cement spacer followed by delayed cancellous bone grafting in three patients. A fourth patient, with a larger defect of 12 cm, had a satisfactory clinical result with this technique, but did not achieve a solid bony union. This method may be considered in contaminated segmental forearm defects amenable to traditional cancellous bone grafting. Thorough debridement, stable fixation, and good soft tissue coverage over the spacer are needed. For larger defects (> 6 cm), other treatment options may be more appropriate.