W. Andrew Eglseder, Jr., MD
Malunion/Nonunion of Radius and Ulna Shaft Fractures
Radius and ulna shaft malunions and nonunions are uncommon occurrences in this age of open reduction and internal fixation (ORIF). Malunions can be thought to occur in radius and ulna shaft fractures managed without operative intervention or internal fixation. Nonunions can be thought of as failure of union, for various reasons, after surgical intervention. However, both malunions and nonunions can occur in conservatively treated radius and ulna fractures. In a 1949 study1 of 41 radius and ulna fractures, 29% had satisfactory results and 71% had unsatisfactory results. Five patients went on to nonunion, a 12% incidence. A later review2 of 41 distal third radial shaft fractures (Galeazzi or Piedmont variants) showed that 38 were treated with closed reduction and casting, and had a 92% failure rate. A number of these cases subsequently went on to surgical intervention. This paper will define anatomic and biomechanic correlations of malunions and nonunions of radius and ulna shaft fractures and provide an overview of treatment options for malunions and nonunions of these fractures.