Injerto óseo vascularizado pediculado del radio distal para tratar la seudoartrosis recalcitrante del cúbito. [Vascularized bone graft of the distal radius for recalcitrant ulnar pseudoarthrosis.]

The purpose of this study was to analyze the clinical and radiological outcomes of a series of patients treated with the pedicled distal radius vascularized bone graft (VBG) for recalcitrant ulnar nonunions. Methods A retrospective study was perfomed. The inclusion criteria were patients with diaphyseal or proximal ulnar nonunions with bone defects smaller than 6 centimeters, at least three previous surgeries and a minimum follow-up of 2 years treated with pedicled VBG of the distal radius. The number of previous surgeries was recorded. The elbow and wrist range of motion, the comparative grip strength, the Visual Analogue Scale (VAS) for pain, the QuickDASH questionnaire and the Mayo Score for elbow were evaluated. Results Seven patients were included. The mean age was 42 years (range 26-64). The average number of previous surgeries was 4 (3-7). The mean follow-up was 21 months (range 24-36). All pseudoarthrosis consolidated. The Mayo score was good in 4 patients, excellent in 2 patients and moderate in one patient. The mean postoperative QuickDASH was 13 (0-29). The flexion-extension arch of the wrist was 81% of the contralateral. The elbow range of motion was > 100° in 5 patients and 50°- 100° in 2 patients. Conclusion The pedicled vascularized bone graft of the distal radius is an effective alternative for the treatment of recalcitrant ulnar nonunions.