A Case of Non-Union of Ulna Fracture Managed with Tibial Strut Cortico-Cancellous Bone Grafting in a Paediatric Patient

Abstract

Forearm fractures in children complicated with non-union are uncommon. Various methods have previously been reported to manage this condition. Well documented techniques would include iliac crest grafting, cancellous insert grafting, ulnar segment grafting, cortical tibial grafting, vascularized fibular grafting and bone transport by ring fixation. The authors present a case of a child with an atrophic non-union of the ulna who was successfully treated with a cortico-cancellous tibial strut bone graft.

Vascularized ulnar periosteal pedicled flap for forearm nonunion in children

“…In the largest series to date (15 patients), a 93% union rate was reported after several different treatments had been performed, including fixation with Kirschner wires, plates, intramedullary nailing and an external fixator with or without a bone autograft (Di Gennaro, 2017). Other smaller series reported less consistent union rates, ranging from 60% to 100%, with the use of traditional treatment methods for non-complex cases (Adamczyk and Riley, 2005; Ballal et al., 2009; Looi et al., 2017). For difficult scenarios, including nonunion related to bone tumours, large bone defects, infection, long-standing nonunions and previous failed treatment, the use of vascularized bone grafts have significantly enhanced union rates (Cano-Luís et al., 2018; Ruiz-Moya et al., 2019).…”