Nonunion of Distal Radius Fractures

Distal radius fractures are a commonly encountered injury in orthopedic surgery, representing the most common upper extremity fracture encountered in the emergency department and accounting for approximately 20% of all fractures occurring in adults. Common complications include median nerve neuropathy, extensor pollicis longus tendon rupture, flexor pollicis longus tendon rupture, radiocarpal arthrosis, infection, and malunion. A less commonly observed complication of distal radius fractures is nonunion of the fracture site, estimated to occur in 0.03%-1.6% of cases. Though rare, nonunions can be a devastating complication, resulting in severe pain and functional limitation. Additionally, even those that are able to be successfully treated often require multiple operative interventions, resulting in increased healthcare costs, time away from work, and risk of infection or other complications. We aim to discuss the current options in the surgical management of this difficult problem.