Internal Fixation of Diaphyseal Fractures of the Forearm

Behnke, Nicole M.; Redjal, Hamid R.; Nguyen, Virginia T.; Zinar, Daniel M.

doi:10.1097/bot.0b013e31824aee8e

Cited by 34 publications

(17 citation statements)

References 37 publications

(40 reference statements)

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“… 15 The posterior interosseous branch of the radial nerve is at risk when proximal locking of radial nail is performed. 15 17 28 The extensor pollicis longus tendon rupture and superficial branch of the radial nerve injuries have been reported in previous studies. 25 29 30 In the present study, locking screw was not used for proximal stability.…”

Section: Discussionmentioning

confidence: 71%

A Newly Designed Intramedullary Nail for the Treatment of Diaphyseal Forearm Fractures in Adults

Azboy

Demirtaş

Alemdar

et al. 2017

IJOO

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Background:The treatment of diaphyseal forearm fractures using open reduction and plate fixation is generally accepted as the best choice in many studies. However, periosteal stripping, haematoma evacuation may result in delayed union, nonunion and infection. Refracture after plate removal is another concern. To overcome these problems intramedullary nails (IM) with different designs have been used with various outcomes. However previous IM nails have some shortcomings such is rotational instability and interlocking difficulties. We evaluated the results of newly designed IM nail in the treatment of diaphyseal forearm fractures in adults.Materials and Methods:32 patients who had been treated with the interlocking IM nail for forearm fractures between 2011 and 2014 were included in this study. There were 23 males and 9 females with mean age of 36 years (range 18-68 years). 22 patients (68.8%) had both bone fractures. Nine patients (28.1%) had open fractures. The remaining ten patients (31.2%) had radius or ulna fractures. Grace and Eversmann rating system was used to assess functional evaluation. Patient reported outcomes were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire scores.Results:Union was achieved in all patients. The mean followup was 17 months (range 13 – 28 months). According to the Grace-Eversmann criteria, 27 patients (87.5%) had excellent or good results. The mean DASH score was 14 (range 5-36). Overall complication rate was 12.5%. Superficial infection was encountered in two patients. One patient had delayed union, however fracture healed without any additional surgical procedure. One patient who had open grade 3A, comminuted proximal third radius fracture developed radioulnar synostosis.Conclusions:The new design IM interlocking forearm nail provides satisfactory functional and radiological outcomes in the treatment of adult diaphyseal forearm fractures.

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Section: Discussionmentioning

confidence: 71%

A Newly Designed Intramedullary Nail for the Treatment of Diaphyseal Forearm Fractures in Adults

Azboy

Demirtaş

Alemdar

et al. 2017

IJOO

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“…Exploration of the proximal radius is hard because of abundance of soft tissue coverage and posterior interosseous nerve. The nails with proximal locking screws possess risk for injury to posterior interosseous nerve [29]. The radial nail that we have used had distal and proximal angulation and in between these angulations curvature of the nail was designed to fit to the radius.…”

Section: Discussionmentioning

confidence: 99%

Alternative treatment of forearm double fractures: new design intramedullary nail

Köse

Aydın

Ezirmik

et al. 2014

Arch Orthop Trauma Surg

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ObjectiveThis study aims to evaluate the results of intramedullary nail treatment in surgical treatment of adult displaced radius and ulna diaphyseal fractures.Patients and methodsEighteen patients (36 forearm fractures) who underwent intramedullary nail treatment due to radius and ulna fractures were retrospectively analyzed. Adult patients with displaced forearm double fractures were included in this study. Patients with open physeal lines, pathological fractures, Monteggia and Galeazzi fractures, distal radioulnar joint instability, bilateral fractures and bone loss were excluded.ResultsThirteen patients were male (72.2 %) and five were female (27.8 %). Average age of the patients was 35.16 (18–63). Twelve patients (66.7 %) suffered right and six patients (33.3 %) left forearm fractures. Average follow-up period was 77.7 (55–162) weeks, average bleeding amount was 51.11 (15–100) ml, average time to bone union was 11.3 (8–20) weeks, average surgery time was 61.94 (45–80) min and average fluoroscopy time was approximately 2 (1–5) min. According to Grace-Eversman criteria, results were excellent in 14 (77.8 %) patients, good in 3 (16.8 %) and acceptable in 1 (5.6 %). Average DASH questionnaire score was 15.15 (4–38.8). There was no iatrogenic vascular, neural and bone injury during surgery. There was late rupture of extensor pollicis longus tendon in one patient, 4 months after surgery.ConclusionIntramedullary fixation method has advantages, such as closed application, short surgery period, good cosmetic results and early return to movement. We think intramedullary fixation method may be used as an alternative treatment method to plate osteosynthesis in surgical treatment of radius and ulna diaphyseal fractures.

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“…There are few comparative studies in the literature related to the fixation of forearm fractures [28,29] . The majority of these comparative studies have examined and evaluated union of the fracture, the forearm pronation and supination degrees obtained at the final follow-up and complication rates.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis

Köse¹,

Engin²,

Topal³

et al. 2019

IKSST

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Objective: In this study we aimed to present the midterm clinical and radiological outcomes of low contact dynamic compression plate fixation of adult forearm fractures. Method: The study included 104 patients with adult forearm fractures who were compatible with the inclusion criteria and have attended the last follow up. Results: The mean time to union was 10,82 weeks. Mean Disabilities of the Arm, Shoulder and Hand (DASH) score was 12.75. There were no cases with implant failure, mechanical irritation, refractures and radioulnar synostoses. 36 patieents were evaluated as perfect, 34 patients as good, 34 patients as acceptable outcomes. No unacceptable outcomes have been obtained. Conclusion: Adult forearm diaphyseal fractures are challenging cases in terms of treatment rehabilitation and complications. In order to prevent medicolegal consequences soft tissues and periosteum must be handled gently and anatomic, rigid, and stable reduction must be obtained in primary surgery. Open reduction and internal fixation with LC DCP' is the golden standart treatmen option for forearm diaphyseal fracture management and perfec radiologic and functional outcomes can be obtained with this method.

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Internal Fixation of Diaphyseal Fractures of the Forearm

Abstract: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Cited by 34 publications

References 37 publications

A Newly Designed Intramedullary Nail for the Treatment of Diaphyseal Forearm Fractures in Adults

A Newly Designed Intramedullary Nail for the Treatment of Diaphyseal Forearm Fractures in Adults

Alternative treatment of forearm double fractures: new design intramedullary nail

Retrospective Evaluation of Adult Diaphyseal Forearm Fractures Result In The Treatment Of Plate Osteosynthesis

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