Abstract
A new method of using a distal ulnar bone block graft pedicled on the dorsal interosseous artery was developed to treat nonunion of the distal radius or ulna. Seventy cadaver upper extremities were injected by latex through humeral arteries and dissected under magnification to investigate the branches from the posterior interosseous artery of the forearm to the ulna. It was found that the dorsal interosseous artery gives off a perforating branch about 2.5 cm proximal to the ulnar styloid to participate in the dorsal carpal vascular network, and two to three constant branches to supply the distal ulna at a level 3 to 4 cm proximal to the ulnar styloid. These branches course along the interosseous membrane and supply the distal part of the ulna. Seven patients with distal forearm bony non-unions (five radius and two ulna) were treated by this procedure. The dorsal interosseous artery was separated with 1 cm of surrounding tissue beneath the radial edge of the extensor capri ulnaris until the periosteal branches to the ulna were observed. A bone block of the distal ulna 1.0 × 3.5 cm in size was harvested with the vascular pedicle and transferred to defects in the radius or ulna. Satisfactory bony healing was achieved about 3.5 months after operation, and a follow-up over 1 year showed good function of the hand. Removal of the bone block did not affect continuity of the ulna or function of the distal radioulnar joint.
Get full access to this article
View all access options for this article.