Table 2.
Patient number | Primary procedure | Reconstruction procedure | Recurrence | Complication | Treatment | Time to union for index surgery (months) |
---|---|---|---|---|---|---|
1 | No | Autologous nonvascularized fibula grafting | No | Nonunion | Iliac bone grafting | 7 |
2 | No | Ulnar translocation | No | Radiocarpal arthritis | none | 8 |
3 | Yes | Ulnar translocation | No | Nonunion | AO plate with persistent asymptomatic pseudoarthrosis | 19 |
4 | No | Ulnar translocation | Yes | Metastasis | Above-elbow amputation | Amputation before union was appreciated§ |
5 | No | Osteoarticular allograft | No | Nonunion, mild arthritis | DC plate iliac bone graft Mild complaints |
16 |
6 | Yes | Osteoarticular allograft | No | Mild arthritis | Mild complaints | 29 |
7 | No | Osteoarticular allograft | No | Plate failure, mild arthritis | Iliac bone grafting, no complaints | 22 |
8 | Yes | Osteoarticular allograft | No | Severe arthritis | None | 15 |
9 | No | Osteoarticular allograft | No | Instability, nonunion | Iliac bone grafting, arthrodesis and TCSA arthrodesis | 13*,† |
10 | No | Osteoarticular allograft | No | Arthritis, joint collapse | TCSA arthrodesis | 14*,† |
11 | No | Osteoarticular allograft | Yes | Fracture, nonunion | TCSA arthrodesis | 11*,† |
12 | Yes | Tibia autograft, interposition arthrodesis | No | None | 12 | |
13 | No | Tibia autograft, interposition arthrodesis | No | None | 12 | |
14 | Yes | Tibia autograft, interposition arthrodesis | No | None | 8 | |
15 | Yes | Tibia autograft, interposition arthrodesis | No | None | 9 | |
16 | Yes | Tibia autograft, interposition arthrodesis | No | Fracture | New tibial strut from contralateral tibia | 12*,†,‡ |
17 | No | Tibia autograft, interposition arthrodesis | No | None | 9 |
* Nonunion revised to arthrodesis; †time to union after revision to tibial autograft interposition arthrodesis; ‡nonunion after fracture, revised and fused after 12 months. Multiple soft tissue metastases developed 3.9 years after tumor resection about the elbow in the subcutis. A distal transhumeral amputation was performed. The retrieval specimen showed stable fusion between the carpal bones and the tibia autograft; §Patient 4 had an amputation before union was noted. Patients 9, 10, and 17 were lost to followup long after their wrist was clinically and radiographically united and free of complaints or pain; TCSA = tibia cortical strut autograft.