One-Bone Forearm Reconstruction: A Salvage Solution for the Forearm with Massive Bone Loss

The Journal of Bone and Joint Surgery. American Volume
Agraharam DevendraShanmuganathan Rajasekaran

Abstract

Salvaging the forearm is a major challenge in cases of massive bone loss from injuries in which the extremity is severely mangled or following bone resection secondary to pathological tissue excision. The purpose of this study was to evaluate the role of one-bone forearm (OBF) reconstruction as a salvage option in these difficult situations. A total of 38 patients with forearm segmental bone loss (acute and chronic) treated between 1995 and 2014 were included (range of follow-up, 2 to 20 years). Sixteen of the patients, 8 with avulsion amputations and 8 with severely mangled extremities, were managed in the emergency department because they required immediate replantation and revascularization, respectively. In the chronic setting, bone loss was due to infection with nonunion in 16 patients, tumor of the radius in 2 patients, and pseudarthrosis of the forearm in 4 patients. The surgical technique included conversion to OBF by achieving union between the distal part of the radius and the proximal part of the ulna in the majority of cases, with distal radioulnar joint (DRUJ) fusion in 4 cases, and ulna to carpals in 5 cases. Direct bone contact was achieved in 16 patients, a free vascularized fibular graft was used to bridge the ...Continue Reading

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Citations

Mar 7, 2021·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Nando FerreiraMaritz Laubscher
Apr 18, 2021·Biochemical and Biophysical Research Communications·Kaiyuan ChengWei Xia
Jun 25, 2021·JBJS Case Connector·Purnaganapathi Sundaram VelmurugesanShanmuganathan Rajasekaran
Sep 12, 2021·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Shingo KomuraHaruhiko Akiyama

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