Functional Outcome of Forearm Fractures Managed With Screw Nails vs. Dynamic Compression Plates: A Prospective Study

Abstract

Background Fractures of the forearm are very frequently encountered in day-to-day practice. These fractures have a bimodal age distribution. The forearm fractures are considered intra-articular and need absolute stability for adequate healing. The current treatment modalities include using intramedullary devices such as a square nail, locking intramedullary nail, or using a plate for fixation. In this study, we aim to determine the functional outcome of forearm fractures managed with a screw nail used as an intramedullary device as compared to a locking plate using the Grace-Eversmann criteria. Methodology Patients with forearm fractures were divided into two groups and treated with a screw nail and a dynamic compression plate. Patients were followed up at one month, three months, six months, and one year postoperatively and assessment was done using the Grace-Eversmann criteria. Results The study included a total of 30 subjects, ranging in age from 18 to 65. The majority of the patients had encountered a road traffic accident, following which they incurred a forearm fracture. Grace-Eversmann criteria was used for these patients at follow-up, and a total of 13 patients (86.6%) had good to excellent scores, which was similar when compared to the plate osteosynthesis group (86.6%). A significant difference in the amount of blood loss was noted in the screw nail osteosynthesis group as compared to the plate osteosynthesis group (p<0.05). Conclusions Though a dynamic compression plate is considered a standard method for fixation of the forearm fractures, the use of an intramedullary screw nail as a fixation device gives a similar result with excellent functional outcomes (Grace-Eversmann criteria). It also gives an added benefit of reduced blood loss and preservation of fracture biology.