Composite bone grafting and plate fixation for the treatment of nonunions of the forearm with segmental bone loss : a report of eight cases

Between June 1986 and December 1991, eight aseptic isolated severe forearm segmental bone losses were treated. The average age of the patients was 26 years. Three cases involved the radius and five the ulna. The average time between the onset of trauma and the final surgical intervention was 9 months. The surgical technique consisted of complete removal of necrotic bone, filling of the bone defect with an intercalary autogenous bone graft, and stable internal fixation, which required combining a plate and an opposite cortical bone allograft. The average bone loss length after freshening the bone ends was 7 cm (range 4-11). The average follow-up was 48 months (range 24-80). In all eight cases union and recovery of forearm function was achieved. The proposed surgical technique proved to be effective in obtaining results with no major complications.