Fracture-related and implant-specific factors influencing treatment results of comminuted diaphyseal forearm fractures without bone grafting

Introduction Recommendations regarding the application of primary autologous bone grafting in the surgical treatment of comminuted diaphyseal forearm fractures are conflicting. Some recent studies suggested that there is no difference in the union rate between simple and comminuted forearm fractures and that the use of bone grafting in the treatment of these fractures is therefore not necessary. Our hypothesis was that among comminuted forearm fractures there is a small group of fractures with a very large extent of comminution that heal with a significantly lower union rate and a prolonged time to union compared with other fractures. We believe that in these fractures bone grafting could help to reduce the time to union and further decrease the rate of nonunion.