Vascularized Bone Grafting From the Base of the Second Metacarpal for Persistent Distal Radius Nonunion

Abstract

Although fractures of the distal radius are relatively common, nonunion is a rare complication. We report a case of a distal radius nonunion in a healthy 51-year-old woman who was involved in a motor vehicle accident. Initial attempts to treat the nonunion with open reduction and internal fixation and corticocancellous bone grafting from the iliac crest failed. Preservation of wrist motion was of considerable importance and wrist arthrodesis was deferred. Treatment of the nonunion with a vascularized bone graft from the base of the second metacarpal, combined with biplanar stable fixation and allogenic bone graft, resulted in union of the fracture and a good functional outcome.