ABSTRACT
Infected forearm nonunion is challenging to treat. We have used a vascularized pedicled bone graft from the distal ulna based on the posterior interosseous artery to treat forearm nonunion with current or previous signs of infection in six patients. Bone union was achieved after a mean of 3.8 months. After a mean follow-up of 25.7 months, no signs of persistent or reactivation of infection were seen in any patient. The mean Quick DASH score significantly improved from 77.4 to 17.6. In addition, the active range of motion of the wrist improved significantly after surgery. In our patients, a vascularized posterior interosseous pedicled bone from the distal ulna is a reliable vascularized bone graft for managing infected forearm nonunion.
Subject(s)
Fractures, Ununited/surgery , Osteomyelitis/surgery , Radius Fractures/surgery , Ulna Fractures/surgery , Ulna/transplantation , Adult , Aged , Debridement , Follow-Up Studies , Fracture Fixation, Internal , Fracture Healing , Hand Strength , Humans , Male , Middle Aged , Ulna/blood supply , Young AdultABSTRACT
Occupational high-pressure injection injuries are not common but can be devastating, especially to the hand. Most of the time, full recovery does not occur. We present a case of high-pressure injection injury to the hand in a patient who worked in a shoe-making factory. As far as we know, this massive involvement of a limb in a high-pressure plastic injection injury has never been reported in the literature. Better controls are required to prevent injection injuries and when they do occur, a high index of suspicion is required with immediate referral for surgical review.
