Treatment of Radius or Ulna Diaphysis Atrophic Non-Unions with Corticocancellous Autograft and Intramedullary Nailing

Abstract

Objective: The purpose of this study was to present the functional and radiological results of tricortical cancellous iliac wing grafting and intramedullary nailing performed with the modified Nicoll’s method for the treatment of cases with radius or ulna atrophic non-union. Methods: The study which is a retrospective clinical study, included 12 patients (8 ulnas, 4 radiuses) with atrophic non-union as a result of plate-screw osteosynthesis applied for a radius or ulna diaphyseal shaft fractures. Fixation was made with tricorticocancellous autograft and intramedullary nailing with the modified Nicoll's method. In the functional and radiological evaluation, a visual analog scale, grip strengths, the Grace-Eversmann scale and the DASH score were used. Forearm pronation and supination and elbow flexion and extension angles were evaluated with goniometer. Results: The patients were comprised of 8 (66.7%) males and 4 (33.3%) females All the patients were followed up for mean 40.5 months (range, 12-84 months). Graft incorporation and remodeling was observed in all patients. According to the Grace-Eversmann scores, 9 patients were evaluated as excellent and 3 as good. Overall, the mean DASH score was 15.5 and the mean VAS score was 1.5. There were no complications about the donor site of the autogenous iliac graft. Conclusion: In cases of isolated radius and ulna non-union with a bone defect (gap) of