The Journal of Bone and Joint Surgery, Vol 69, Issue 5 640-653, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Cross-union complicating fracture of the forearm. Part I: Adults
KG Vince and JE Miller
The cases of twenty-eight adults who had cross-union as a complication of
fractures of the forearm were analyzed according to a new classification
system. Four cross-unions were Type 1 (distal intra-articular part of the
radius and ulna); fourteen, Type 2 (middle third or non-articular part of
the distal third of the radius and ulna); and ten, Type 3 (proximal third
of the radius and ulna). Type-1 cross-union occurred rarely, but it
developed most commonly after closed reduction of a fracture. Types 2 and 3
typically followed severe local trauma and delayed open reduction. Bone
fragments left in the interosseous space and bone screws that broached the
opposite part of the cortex were common findings. Seventeen cross-unions
were excised. Three of the four Type-1, none of the ten Type-2, and two of
three Type-3 cross-unions recurred. The results after excision of Type-2
cross-unions in our series were far better than other results that have
been previously reported.
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