Management of diaphyseal ulnar nonunion: Current concepts. A literature review
Keywords:
ulna, nonunion, diaphyseal ulnar non-union, bone healingAbstract
Background and aim: Non-union of the ulna presents a significant challenge in orthopedic surgery, often resulting in prolonged pain, dysfunction, and impaired quality of life for patients. The term non-union refers to the failure of bone healing following a fracture, leading to persistent symptoms and functional impairment. Despite advancements in surgical techniques and implant technologies, non-union remains a vexing complication with potential long-term consequences. This review synthesizes, based on the existing literature available, risk factors, type of surgery or second surgery, eventual bone grafts used and management strategies associated with non-union of the ulna.
Methods: A comprehensive research of the PubMed database was conducted to identify relevant studies on non-union of the ulna. We took into account only full-text articles in indexed journals with available English abstracts, without focusing on clinical studies, case reports, systematic reviews and studies on cadaver or animals.
Results: In this study 27 articles were included, involving a total of 1.706 patients. The average age of patients were 34,3±18.8 years and the mechanisms of trauma were widely. Studies mainly describe diaphyseal fracture, categorized into 62 atrophic, 51 oligotrofic and 43 hypertrophic nonunion cases. Only 2 cases of septic non-union were described. Different fixation techniques were employed, besides functional outcomes demonstrated significant improvements in the range of motion for both the wrist and elbow.
Conclusions: In conclusion, this review highlights the complex nature of non-union of the ulna and underscores the importance of further research to better understand its pathogenesis and optimal management strategies. While the literature provides valuable insights into risk factors and treatment outcomes, gaps in knowledge remain, necessitating continued investigation to improve patient outcomes and quality of care.
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Copyright (c) 2025 Giulia Maria Sassara, Giuseppe Rovere , Omar El Ezzo, Rocco De Vitis , Federico Moretti, Silvia Marino, Roberta Righini, Adele Arnone, Guido Bocchino, Fernando De Maio , Domenico De Mauro , Amarildo Smakaj, Francesco Liuzza
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