Forearm Fractures: Diagnosis and Contemporary Treatment Strategies.

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Abstract

[Indexed for MEDLINE] 4. J Hand Surg Am. 2020 Nov;45(11):1055-1064. doi: 10.1016/j.jhsa.2020.05.030. Epub 2020 Aug 13. Forearm Nonunion: Characterization and Management. Srinivasan RC(1), Hutson RL(2), Richard MJ(3). Author information: (1)Hand Center of San Antonio, Department of Orthopedic Surgery, University of Texas Health San Antonio, San Antonio, TX. Electronic address: rameshcsrinivasan@gmail.com. (2)Hand Center of San Antonio, Department of Orthopedic Surgery, University of Texas Health San Antonio, San Antonio, TX. (3)Department of Orthopedic Surgery, Duke University, Durham, NC. Adult forearm nonunion should be investigated prior to developing a treatment strategy: "Why did the fracture not heal?" Optimizing the patient's biology and the stability at the nonunion site are critical for a successful outcome. This review concisely discusses the initial work-up, including history, physical examination, imaging, and laboratory testing, as well as available surgical techniques-irrigation and debridement with deep cultures, revision open reduction internal fixation with or without biological adjuvant therapies, cancellous autograft, tricortical iliac crest, reamer/irrigator/aspirator, allograft, vascularized free-fibula and induced-membrane technique. Copyright © 2020 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.jhsa.2020.05.030