One bone forearm with vascularized fibular graft. Clinical experience and literature review

The one-bone forearm (OBF) is a salvage technique that may be used to correct global forearm instability secondary to osseous defects. This study aims to provide an overview of the contemporary literature regarding the OBF. A literature review was conducted electronically across MEDLINE, Embase, and PubMed databases in May 2020. Studies were eligible for inclusion if published in the English language; detailed the use of the OBF procedure to correct forearm instability; and were original data studies reporting qualitative or quantitative outcomes. Thirty-four studies, describing a cohort of 210 patients undergoing 211 OBFs, were documented in the literature. The primary etiology necessitating the OBF was trauma, followed by genetic/congenital disorders and infections. Technically, the OBF was most frequently achieved via an end-to-end osteosynthesis with plate fixation. In total, 85.0% (154/182) of OBF were fused in neutral rotation or varying degrees of pronation. Union was achieved in more than 80.0% (174/211) of OBFs. The OBF is a feasible salvage technique that has been used for a wide spectrum of pathology, providing satisfactory outcomes in most cases.

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“…Manual review of reference lists from each study yielded an additional 15 studies for inclusion and analysis. 1,2,4-35 See Figure 2.…”

Section: Resultsmentioning

confidence: 99%

The One-Bone Forearm: A Review

Multani

Manji

et al. 2022

Hand (New York, N,Y.)

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“…Other different techniques were described using a vascularized fibular graft [11], a free fibula flap [12], a different fixation [13], or adding a fusion of the distal radioulnar joint [14].…”

Section: Discussionmentioning

confidence: 99%

Modified Technique of Single-Bone Forearm in the Treatment of Deformities

Benameur¹,

Bensaleh²,

Alidrissi³

et al. 2022

Cureus

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“…Despite the high integration potential owing to the rich blood supply, VFBG is timeconsuming and may cause donor-site morbidities. 5,[8][9][10][11][12][13] Alternatively, pedicled bone flaps can be used with more straightforward techniques. We have previously proposed the antegrade posterior interosseous bone flap (PIBF) for complex nonunion of the forearm in adults.…”

mentioning

confidence: 99%

“…It is a complicated microsurgical procedure that requires sophisticated techniques and instruments. Despite the high integration potential owing to the rich blood supply, VFBG is time-consuming and may cause donor-site morbidities 5,8–13…”

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confidence: 99%

Treatment of Recalcitrant Nonunion of the Radius With Posterior Interosseous Bone Flap in Children

Kamrani

Jehanno

Arabzadeh

et al. 2021

Journal of Pediatric Orthopaedics

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Background: Forearm nonunion is a rare condition in children, and its treatment is usually successful. However, nontraumatic nonunion can be resistant to treatment. Although the vascularized fibular bone graft has been frequently used for complex forearm nonunion, there is no consensus on the best treatment method. In this study, we aimed to investigate the outcome of the antegrade posterior interosseous bone flap (PIBF) in treating children with complex radius nonunion. Methods: The participants consisted of 3 girls and 1 boy ranging from 31 months to 9 years of age. They were treated with PIBF surgery, and the nonunion of the radius was fixed with a plate or an external fixator. The nonunion was due to congenital pseudoarthrosis, osteogenesis imperfecta, or infantile osteomyelitis. All patients were evaluated for a clinical and radiologic union. Results: The radiologic union was achieved 2 to 3 months after the surgery in all cases. The functional recovery of the elbow, forearm, and wrist was satisfactory except for 1 patient who experienced donor site fracture, and finally radioulnar synostosis accompanied by radial head dislocation. Conclusion: Because of the simplicity of its technique and short duration of surgery, PIBF can be a reliable and less-demanding alternative to vascularized fibular bone graft in the treatment of complex forearm nonunion in children. Level of Evidence: Level IV.

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One bone forearm with vascularized fibular graft. Clinical experience and literature review

Cited by 5 publications

References 14 publications

The One-Bone Forearm: A Review

The One-Bone Forearm: A Review

Modified Technique of Single-Bone Forearm in the Treatment of Deformities

Treatment of Recalcitrant Nonunion of the Radius With Posterior Interosseous Bone Flap in Children

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