Abstract
The one-bone forearm is a salvage procedure that can be used in chronic distal radio-ulnar joint instability, therefore sacrificing pronation-supination in order to reduce pain. Failed consolidation is a common complication and associated with several risk factors. Many authors insist on the need for rigid fixation, combining bone grafting, internal fixation and external fixation together when faced with complicated upper-limb reconstruction.
Highlights
ConclusionOur hypothesis is that the new biomechanical constraints created in a one-bone forearm can be so high that they exceed the stabilizing capacities of an internal plate and traditional plaster cast, resulting in repeated non-union
The one-bone forearm is a salvage procedure that can be used in chronic distal radio-ulnar joint instability, sacrificing pronation-supination in order to reduce pain
Our hypothesis is that the new biomechanical constraints created in a one-bone forearm can be so high that they exceed the stabilizing capacities of an internal plate and traditional plaster cast, resulting in repeated non-union
Summary
Our hypothesis is that the new biomechanical constraints created by the OBF procedure can be so high that they exceed the stabilizing capacities of an internal plate and traditional plaster cast, resulting in repeated non-union. This is especially true for patients with traumatic aetiology or multiples previous surgical procedures, where bone vascularisation has been compromised by scar tissue. Considering that the OBF is a salvage procedure, most patients belong to this category, we recommend immediate external fixation in all patients
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