Evaluation of outcomes in aseptic non-unions of the forearm bones in adults treated with LCP and autograft

BACKGROUND: The aim of the present study was to evaluate the effect of locking compression plate (LCP) and autografting application in patients with nonunion of forearm fractures on radiologic and clinical outcome.
METHODS: A total of 26 patients (16 males, 10 females; mean age: 45.7 years) with nonunion after surgical treatment of forearm fractures were included. Nonunion was located in the ulna in 14 patients, in the radius in 5 patients, and in both in 7 patients (21 ulna, 12 radius).Infection markers were checked prior to surgery. Samples for microbiologic cultures were peroperatively obtained in 7 patients with a history of open fractures. Autografting from the iliac crest and 3.5-mm LCP were applied. Type of nonunion, time to unification, range of motion in the wrist and elbow joints, and complications were analyzed. Functional evaluation was performedusing the scoring system described by Anderson et al.
RESULTS: Mean follow-up period was 49.3 months (range 24–73 months). Unification was achieved in a mean 5.7 months (range 3–14 months). Additional surgical process was not required. No bacterial proliferation was observed in cultures. Superficial infection was observed in 3 patients and deep infection in 1. Results were scored as excellent in 10 (38.4%) patients, satisfactory in 13 (50%), and unsatisfactory in 3 (11.6%).
CONCLUSION: Treatment of aseptic forearm nonunion in adults with autografting from the iliac crest and 3.5-mmLCP fixation increases unification rate and aids in function recovery.

Eriþkin ön kol kemiklerinin aseptik kaynamama tedavisinde LCP ve otogreft

AMAÇ: Bu çalýþmanýn amacý eriþkin ön kol kemiklerinde aseptik kaynamama geliþen hastalarda kilitli kompresyon plaðý (LCP) ve otogreft kullanýmýnýn radyolojik ve klinik iyileþme üzerine etkinliðini deðerlendirmektir.
GEREÇ VE YÖNTEM: Ön kol cisim kýrýklarý sonrasý kaynamama geliþen ve cerrahi yöntemle tedavi edilen 26 hasta (16 erkek, 10 kadýn; ortalama yaþ 45.7 yýl) çalýþmaya alýndý. On dört hastada ulna, beþ hastada radius ve yedi hastada her iki kemikte (21 ulna, 12 radius) kaynamama mevcuttu. Cerrahi öncesinde enfeksiyonu deðerlendirmek için enfeksiyon belirteçleri bakýldý. Açýk kýrýk öyküsü olan yedi hastadan cerrahi sýrasýnda kültür alýndý. Hastalar 3.5 mm kilitli kompresyon plaðý ve iliak kanattan alýnan otogreft ile tedavi edildi. Hastalarýn kaynamama tipi, kaynama süreleri, cerrahi sýrasýnda greft kullanýmý, el bileði ve dirsek hareketleri, geliþen komplikasyonlar sorgulandý. Fonksiyonel deðerlendirme Anderson ve ark.nýn tanýmladýðý sisteme göre yapýldý.
BULGULAR: Takip süresi ortalama 49.3 aydý (daðýlým 24–73 ay). Tüm hastalarda ortalama 5.7 ayda (daðýlým 3–14 ay) kaynama saðlandý. Ýlave cerrahi gereken hasta olmadý. Cerrahi sýrasýnda alýnan kültürlerde bakteri üremesi gözlenmedi. Üç hastada yüzeysel, bir hastada derin enfeksiyon geliþti. Anderson ve ark.nýn deðerlendirme sistemine göre 10 hastada (%38.4) mükemmel sonuç, 13 hastada (%50) yeterli sonuç ve üç hastada (%11.6) yetersiz sonuç elde edildi.
TARTIÞMA: Aseptik önkol kaynamamalarýnýn tedavisinde 3.5 mm LCP ile tespit ve beraberinde iliak kanattan alýnan otogreft kullanýmý kaynama oranýný artýrmakla beraber fonksiyonel iyileþmeye yardýmcý olmaktadýr.