Treatment of nonunion of the forearm bones with posterior interosseous bone flap

Kamrani, Reza Shahryar; Mehrpour, Saeed Reza; Sorbi, Reza; Aghamirsalim, Mohamadreza; Farhadi, Leila

doi:10.1007/s00776-013-0395-0

Cited by 26 publications

(29 citation statements)

References 15 publications

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“…Most VPFs have been previously described in some other format, including vascularized bone or fascio-cutaneous flaps, 8,21 especially in adult patients. Therefore, the VPFs presented here must be considered modifications from the previous ones, elevating the periosteum alone.…”

Section: Discussionmentioning

confidence: 99%

“…15,20 Open reduction and internal fixation with or without autologous or heterologous bone graft remains the most frequent treatment method. 16,21 The complexity of treating these lesions is usually increased by their association with poor bone quality, small, difficult to stabilize bone fragments, and previous surgeries and approaches that compromise bone consolidation and viability.…”

Section: Clinical Usefulnessmentioning

confidence: 99%

“…15,16 Forearm pseudoarthrosis is severely disabling because the dysfunction extends from the elbow to the wrist. [21][22][23][24]…”

Section: Periosteal Vascularized Flaps From the Forearm Anatomymentioning

confidence: 99%

“…It has an optimal size for small defects of up to 4 cm 2 . The length of its pedicle (5.2 cm) allows it to be used both for scaphoid pseudoarthrosis and/or avascular necrosis either by a volar and dorsal approach [17][18][19][20][21][22][23][24][25] . It can also be used for semilunar necrosis or Kienböck disease through a dorsal approach, although 4-5 radial VPFs are often preferred in such cases.…”

Section: Clinical Usefulnessmentioning

confidence: 99%

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Use of Vascularized Periosteal Flaps in Upper Extremity Pathology

Alabau-Rodriguez

Liburd

González

et al. 2020

Revista Iberoamericana de Cirugía de la Mano

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Massive bone defects represent a challenge in orthopedics. The structural and biological contribution of vascularized bone flaps has significantly improved their treatment. Similarly, free vascularized periosteal flaps (VPF) have been used to treat bone defects in children, with higher flexibility, adaptability to the recipient's bed and good osteogenic and osteoinductive capacity. However, these are complex techniques related to donor area morbidity. We have started anatomical and clinical studies on the application of pediculated VPF in recalcitrant massive defects to reduce this morbidity. This article summarizes the fundamental aspects of the surgical technique, the main anatomical findings from cadaveric dissections and the applicability of pediculated VPF to treat biologically unfavorable bone defects at the upper limb. The authors review the vascularized humeral periosteal flap (VHPF), the dorso-ulnar and volar-radial forearm periosteal flaps and the vascularized first metacarpal periosteal flap, all described in previous papers. As a novelty, the dorsal wrist and hand VPF (4-5 radial periosteal flap and dorsum of the second metacarpal bone periosteal flap) are presented. In addition, clinical cases with recent VPF applications in common upper limb conditions are described.

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Usefulnessmentioning

confidence: 99%

“…15,16 Forearm pseudoarthrosis is severely disabling because the dysfunction extends from the elbow to the wrist. [21][22][23][24]…”

Section: Periosteal Vascularized Flaps From the Forearm Anatomymentioning

confidence: 99%

Section: Clinical Usefulnessmentioning

confidence: 99%

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Use of Vascularized Periosteal Flaps in Upper Extremity Pathology

Alabau-Rodriguez

Liburd

González

et al. 2020

Revista Iberoamericana de Cirugía de la Mano

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“…The harvesting technique used for the VUPPF followed most of the standard steps used to obtain a reverse posterior interosseous flap (Akin, Ozgenel, & Ozcan, ; Cheema, Lakshman, Cheema & Durrani, ; Costa & Soutar, ; Kamrani, Mehrpour, Sorbi, Aghamirsalim, & Farhadi, ; Penteado, Masquelet, Romana, & Chevrel, ). The elbow was flexed to a right angle and the lateral epicondyle and distal radio‐ulnar joint marked on the skin.…”

Section: Case Reportmentioning

confidence: 99%

Vascularized ulnar periosteal pedicled flap for forearm reconstruction: Anatomical study and a case report

et al. 2017

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Vascularized pedicled bone graft from the distal radius supplied by the anterior interosseous artery for treatment of ulnar shaft nonunion: An anatomical study of cadavers and a case report

et al. 2020

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BackgroundA vascularized distal radius graft can be a reliable solution for the treatment of refractory ulnar nonunion. The aim of this study is to establish the anatomical basis of a vascularized bone graft pedicled by the anterior interosseous artery and report its clinical application, using cadaveric studies and a case report.MethodsFourteen fresh frozen cadaveric upper limbs were used. The branches of the anterior interosseous artery (the 2, 3 intercompartmental supraretinacular artery and the fourth extensor compartment artery) were measured at the bifurcation site. The anatomical relationship between the anterior interosseous artery and motor branches of the posterior interosseous nerve was investigated. An anterior interosseous artery pedicled bone flap was used in a 48‐year‐old woman with refractory ulnar nonunion.ResultsThere were two variations depending on whether the 2,3 intercompartmental supraretinacular artery branched off distally or proximally from the terminal motor branch of the posterior interosseous nerve. The proximal border of the graft was located at an average of 10.5 cm (range, 6.5–12.5 cm) from the distal end of the ulnar head in the distal type (57%) and 17.5 cm (range, 9.5–21.5 cm) in the proximal type (43%). In the clinical application, successfully consolidation was achieved 4 months post‐surgery. The patient had not developed any postoperative complications until the 2‐year postoperative follow‐up.ConclusionsThe anterior interosseous artery‐pedicled, vascularized distal radius bone graft would be a reliable alternative solution for the treatment of an ulnar nonunion located within the distal one‐third of the ulna.

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Treatment of nonunion of the forearm bones with posterior interosseous bone flap

Cited by 26 publications

References 15 publications

Use of Vascularized Periosteal Flaps in Upper Extremity Pathology

Use of Vascularized Periosteal Flaps in Upper Extremity Pathology

Vascularized ulnar periosteal pedicled flap for forearm reconstruction: Anatomical study and a case report

Vascularized pedicled bone graft from the distal radius supplied by the anterior interosseous artery for treatment of ulnar shaft nonunion: An anatomical study of cadavers and a case report

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