Treatment of forearm nonunion with iliac crest graft and a Hunec nail.

Forearm bone loss is usually the result of high-energy trauma or complications or failures in managing simple fractures. Material and methods: a total of 38 patients were reviewed, with 44 lesions diagnosed as forearm bone loss resulting from nonunion, both aseptic and infected, where a Hunec nail was used as an implant and the defects were replaced with iliac crest fragments. The bones involved included 26 ulnas and 18 radii; they had been managed with previous surgical procedures, most of them with plates as implants. Infected cases were treated following the Colchero protocol. Iliac crest fragments were used to replace the bone defects ranging from 3 to 7.5 cm in length, with an average of 5.2 cm, and a Hunec nail was inserted as an implant. Results: the mean operative time was about 90 minutes. Except for 4 cases, all lesions healed within approximately 16 weeks. Combining an implant that provides optimum stability with a mean osteogenic supply rapidly integrating and geometrically adapting to the forearm bone shaft highlights the method advantages. [ABSTRACT FROM AUTHOR]