Purpose The purpose of this study was to describe a technique of end-to-end rigid fixation of the distal radius to the proximal ulna . The shortening and radioulnar overlap in this technique yield a high union rate, large corrections, and few complications. Methods This retrospective chart review from 2 centers was undertaken in 39 patients (40 forearms) who underwent one-bone forearm operations between 2005 and 2019. There were 25 male and 14 female patients, with a mean age at surgery of 9.7 years (range 3 to 19 years; SD, 4.5 years). The diagnoses included brachial plexus birth injury, spinal cord injury , arthrogryposis multiplex congenita , cerebral palsy , ulnar deficiency with focal indentation, multiple hereditary exostosis , acute flaccid myelitis , and tumor. Results The average follow-up was 33.5 months (1.2–110.1 months; SD, 27.1 months). The 36 forearms in supination had an average supination contracture of 93° (range, 15° to 120°; SD, 15.4°). The 4 pronated arms had an average pronation contracture of 80° (range, 50° to 120°; SD, 29.2°). The average postoperative position was 22.8° of pronation (range, –15° to 45°; SD, 12.9°). The average correction obtained with our technique was 113° (range, 20° to 145°; SD, 22.9°). Radiographic union was demonstrated in 32 (80%) of the one-bone forearms by 10 weeks, 39 (97.5%) by 16 weeks, and 40 (100%) by 24 weeks. One patient had peri-implant fractures prior to union. No forearms required reoperation for nonunion . Conclusions One-bone forearm performed with this technique allows reliable healing and a large degree of correction. Type of study/level of evidence Therapeutic IV.
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