To determine the union rate of forearm fractures where acute bone grafting was recommended but not performed.

Retrospective review.

Regional level one trauma center.

The criteria for inclusion in the study were patients with closed growth plates and a diaphyseal fracture of the radius, ulna, or both (including Monteggia and Galeazzi fracture-dislocations) that were treated with plate fixation. Patients were excluded from the study if they were lost to follow-up before radiographic documentation of bone union. The review identified 198 fractures that were eligible for inclusion. Fifteen fractures were excluded.

The method of treatment of each fracture was open reduction and plate fixation with or without bone grafting.

Fracture union.

The overall union rate in comminuted, nongrafted forearm fractures (open and closed) was 98% (99/101; 95% confidence interval: 93-100%). The union rate in closed, comminuted, nongrafted forearm fractures was 97% (74/76; 95% confidence interval; 91-100%).

Open reduction and internal fixation of comminuted diaphyseal forearm fractures without bone grafting in this study produced union rates comparable to those reported for open reduction and internal fixation of comminuted forearm fractures with acute bone grafting. This study suggests that routine use of bone grafting in comminuted forearm fractures is not indicated.

Polls results

On a scale of 1 to 10, rate how much this article will change your clinical practice?

NO change
BIG change
94% Article relates to my practice (82/87)
3% Article does not relate to my practice (3/87)
2% Undecided (2/87)

Will this article lead to more cost-effective healthcare?

73% Yes (61/83)
22% No (19/83)
3% Undecided (3/83)

Was this article biased? (commercial or personal)

11% Yes (9/79)
68% No (54/79)
20% Undecided (16/79)

What level of evidence do you think this article is?

2% Level 1 (2/95)
18% Level 2 (18/95)
49% Level 3 (47/95)
27% Level 4 (26/95)
2% Level 5 (2/95)