Treatment of Distal Radius Fracture Nonunion With Posterior Interosseous Bone Flap

Iran Red Crescent Med J. 2016 Jun 28;18(7):e38884. doi: 10.5812/ircmj.38884. eCollection 2016 Jul.

Abstract

Background: Nonunion of distal radius fractures is disabling. Treatment is difficult and the results are not predictable. However, posterior interosseous bone flap (PIBF) has been successful in treating forearm nonunion.

Objectives: To treat distal radius fracture nonunion with PIBF as a new procedure.

Patients and methods: This prospective non-randomized cohort study was performed at two hospitals in Tehran between January 2011 and September 2015. PIBFs were applied in nine patients (10 nonunions) with a mean age of 55 years. Union success rate, grip strength, wrist range of motion, and forearm rotation were then evaluated.

Results: Although four of the patients had a history of infection, all participants achieved fracture union at a mean time of 3.8 months. Grip strength improved by 12.4 kg. There was also 36° improvement in wrist flexion, 20° improvement in wrist extension, 60° improvement in forearm supination, and 46° improvement in forearm pronation. The range of motion and grip strength improvements were significant.

Conclusions: Pedicled PIBF is a new option for treating distal radius fracture nonunion. The results are predictable in achieving union and good function, and this technique can be successfully used in cases with extensive soft-tissue damage or infection.

Keywords: Distal Radius Fracture; Nonunion; Posterior Interosseous Flap; Treatment.