Comparison of the clinical and radiographic outcomes of plate fixation versus new-generation locked intramedullary nail in the management of adult forearm diaphyseal fractures

Polat, Oktay; Toy, Serdar

doi:10.5152/j.aott.2022.21190

Cited by 6 publications

(6 citation statements)

References 40 publications

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“…In our study, the right side was more common in both groups. Ambhore et al [2] and Polat et al [20] studies also had a majority of fractures in the right forearm, which is correlated with our study. In this study, both groups were statistically similar in terms of age, gender, and side of injury.…”

Section: Discussionsupporting

confidence: 92%

A Comparative Study Between Plate Osteosynthesis and Intramedullary Nailing for Diaphyseal Fracture of Radius and Ulna in Adults

Saini¹,

Sharma²,

Baisoya³

et al. 2023

Cureus

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Introduction: In this era of active living, industrial growth, increasing automobile accidents, and athletic activities, fractures of the forearm bones are becoming more frequent. The incidence of diaphyseal fractures of both bone forearms is reported to be approximately 10 per 10,000 persons per year, although rates may vary according to age and sex. If not properly treated, a fracture of the forearm bones might cause a serious loss of function. Therefore, to restore function, these fractures require adequate anatomical reduction and internal fixation. The majority of forearm fractures in adults are treated surgically, and various modes of internal fixation are available. In this study, we evaluated and compared the clinical, functional, and radiological outcomes of both bone forearm diaphyseal fractures treated with plate osteosynthesis and intramedullary nailing.Material and method: This prospective and comparative study was conducted in a tertiary care medical teaching hospital in southern Rajasthan, India. Forty patients with diaphyseal fractures of the radius and ulna bones who presented to the casualty or orthopedic outpatient departments of our institute were included. Patients were divided into two groups, 20 patients in each group and treated by intramedullary nailing (group A) and plate osteosynthesis (group B), and regularly followed up and evaluated for clinical, functional, and radiological outcomes.Result: Final results were calculated according to the modified Grace-Eversmann scoring system. In group A, out of 20 cases excellent score was seen in six cases (30%), good score in nine cases (45%), fair score in three cases (15%), and at last, two cases (10%) showed poor results. In group B, excellent score was in eight cases (40%), good score was in eight cases (40%), fair score was in three cases (15%), and at last, one case (5%) was poor in our study.Conclusion: Based on our findings, we conclude that for the treatment of diaphyseal fractures of the radius and ulna, both treatment modalities provide equally satisfactory results.

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Section: Discussionsupporting

confidence: 92%

A Comparative Study Between Plate Osteosynthesis and Intramedullary Nailing for Diaphyseal Fracture of Radius and Ulna in Adults

Saini¹,

Sharma²,

Baisoya³

et al. 2023

Cureus

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“…In a study conducted by Polat et al 18 with a group of 46 patients who underwent new-generation IMN and plate osteosynthesis for forearm fractures, the mean union time was 10.9 weeks in the IMN group and 13.2 weeks in the plate group, with union being faster among patients who underwent IMN. In their study including 100 patients, Savajiyani et al 19 achieved adequate union in 88 cases using IMN and reported union times compatible with other studies in the literature.…”

Section: Discussionmentioning

confidence: 97%

Comparison of clinical and functional outcomes of patients who underwent plate osteosynthesis and intramedullary nailing for forearm fractures

Ateş,

Altıntaş

2024

J Med Palliat Care / JOMPAC / Jompac

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Aims: The aim of this study was to compare the functional and radiographic results of patients with forearm diaphyseal fractures after intramedullary nailing (IMN) and plate and screw osteosynthesis. Methods: A total of 58 patients, including 31 patients operated on with the plate osteosynthesis method and 27 patients operated on with the IMN method for forearm diaphyseal fractures between 2017 and 2022, were retrospectively analyzed. The mean age was 35.9±14.5 years in the plate group and 33±13.1 years in the IMN group. The mean follow-up period was 157±83 days in the IMN group and 220±97 days in the plate group. Evaluation criteria for functional outcomes were forearm pronation; supination range of motion; the Disabilities of the Arm, Shoulder, and Hand (DASH) score; and the Grace-Eversmann score. Results: The mean union time was 66.7 days in the plate group and 54.4 days in the IMN group (p=0.039). The mean length of hospitalization was 3.9±3.44 days in the plate group and 2.93±1.49 days in the IMN group. The mean supination range was 72.5±9.9 degrees in the plate group and 72.2±11.8 degrees in the IMN group. The mean pronation range was 81.2±11.7 degrees in the plate group and 80.3±15.5 degrees in the IMN group. The mean follow-up period was 157±83 days in the IMN group and 220±97 days in the plate group (p=0.011). According to the Association for Osteosynthesis/Orthopedic Trauma Association (AO/OTA) classification, 30 cases were classified as type A, 21 cases as type B, and 7 cases as type C. According to the Grace-Eversmann classification, 2 cases in the plate group were classified as unacceptable, 2 were classified as acceptable, 10 were classified as good, and 16 were classified as excellent, while 2 cases in the IMN group were classified as unacceptable, 4 were classified as acceptable, 5 were classified as good, and 16 were classified as excellent. The mean DASH score was 14.74±10.49 in the plate group and 15.11±12.7 in the IMN group. Conclusion: With the advantages of minimal incision, less soft tissue damage, and no evacuation of the fracture hematoma, the union time and follow-up periods were found to be shorter in the IMN group. Thanks to the bearing force of intracanal intramedullary nails, patients were able to move earlier and satisfactory functional outcomes were obtained.

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“…IM nail techniques minimize damage to soft tissue and the periosteum and promote secondary callus formation, providing a better alternative. The recently developed interlocking IM nailing method prevents not only rotational stability of the fracture, but also bone shortening [ 8 , 9 , 14 , 15 ]. Some researchers have suggested that comminuted fractures, segmental fractures, and fractures near the diaphyseal-metaphyseal junction are appropriate indications for interlocking IM nailing in forearm fractures [ 3 , 5 , 7 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, in our study, IM nailing alone resulted in a higher incidence of non-union and changes in bone length. Polat et al [ 14 ] compared two groups who were treated with IM nails and plates, finding that distant locked IMNs are a viable alternative to ORIF with plate osteosynthesis with similar healing rates, functional scores, and shorter operative times. In that study, there were only three patients with diaphyseal fractures, making it difficult to conclude that this method is also useful for treating segmented fractures.…”

Section: Discussionmentioning

confidence: 99%

“…In that study, there were only three patients with diaphyseal fractures, making it difficult to conclude that this method is also useful for treating segmented fractures. In other previous studies, IM nailing in forearm bone fractures was used for simple, non-segmental fractures [ 4 , 9 , 10 , 14 , 15 , 17 ]. Our results were different from previous results, and are the core of our study implications.…”

Section: Discussionmentioning

confidence: 99%

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Surgical outcomes of segmental diaphyseal forearm fractures in adults: a small case series on plate osteosynthesis, intramedullary nailing, and other surgical methods

Kim,

Jang,

Kwak

et al. 2023

BMC Musculoskelet Disord

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Background Segmental fractures often result from high-energy or indirect trauma that causes bending or torsional forces with axial loading. We evaluated surgical outcomes of patients with forearm segmental diaphyseal fractures. Methods We retrospectively analyzed data from patients with forearm segmental fractures for which they underwent surgery at the Pusan National University Trauma Center from March 2013 to March 2022. We also analyzed accompanying injuries, injury severity score (ISS), injury mechanism, occurrence of open fracture, surgical technique, and treatment results. Results Fifteen patients were identified, one with bilateral segmental diaphyseal forearm bone fracture, for a total of 16 cases. Nine of the patients were male. The overall mean age was 50 years, and the mean follow-up period was 16.2 months. Six cases who underwent surgery using plate osteosynthesis achieved bone union without length deformity at final follow-up. Three of seven patients who underwent intramedullary nailing alone underwent reoperation due to nonunion. Six cases achieved bone union at final follow-up, three of which showed length deformity. Three patients underwent surgery using a hybrid method of IM nailing, plates, and mini cables. One patient who underwent surgery with a plate and one patient who underwent surgery with IM nailing alone showed nonunion and were lost to follow-up. Conclusion Plate osteosynthesis is considered the gold standard for treatment of adult forearm diaphyseal segmental fractures. In this study, IM nailing was associated with high rates of non-union and length deformity. However, the combination of IM nailing and a plate-cable system may be an acceptable alternative in segmental diaphyseal forearm fracture, achieving a union rate similar to that provided by plate fixation.

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Comparison of the clinical and radiographic outcomes of plate fixation versus new-generation locked intramedullary nail in the management of adult forearm diaphyseal fractures

Cited by 6 publications

References 40 publications

A Comparative Study Between Plate Osteosynthesis and Intramedullary Nailing for Diaphyseal Fracture of Radius and Ulna in Adults

A Comparative Study Between Plate Osteosynthesis and Intramedullary Nailing for Diaphyseal Fracture of Radius and Ulna in Adults

Comparison of clinical and functional outcomes of patients who underwent plate osteosynthesis and intramedullary nailing for forearm fractures

Surgical outcomes of segmental diaphyseal forearm fractures in adults: a small case series on plate osteosynthesis, intramedullary nailing, and other surgical methods

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