Treatment of adult isolated ulnar diaphyseal fractures: A comparison of new-generation locked intramedullary nail and plate fixation

Kibar, Birkan; Kurtulmuş, Tuhan

doi:10.5606/ehc.2019.66344

Cited by 5 publications

(7 citation statements)

References 16 publications

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“…In previous studies on adult forearm fractures, the fluoroscopy time in patients who underwent IMN (1.2-7 minutes) was significantly longer than that in patients who were treated with plate osteosynthesis (0-2 minutes). 14 , 17 , 18 , 35 , 37 , 38 In our study, which is consistent with the literature, fluoroscopy time was significantly longer in patients who underwent IMN (21.3 seconds) than in patients who underwent plate osteosynthesis (2.7 seconds). The long fluoroscopy time was the major disadvantage of using IMNs.…”

Section: Discussionsupporting

confidence: 91%

“…When the studies in the literature were examined, it was found that the operative time in patients with forearm fractures was shorter in the patient groups in which IMN (range, 43-61 minutes) was applied than in the patient groups in which osteosynthesis with the plate (range, 63-74 minutes) was used. 17 , 18 , 35 , 37 Patients in the IMN group had a much shorter operative time (69.7 [range, 45-110] minutes) than patients in the plate group (88.2 [range, 50-130] minutes) in our study. As the incisions were small and the procedure was simple, the surgery required less time.…”

Section: Discussionmentioning

confidence: 52%

“…Kose et al 37 considered both isolated radius and ulna fractures and fractures of both forearms. Kibar et al 18 , 35 considered isolated radius and isolated ulna fractures in their studies. Azboy et al 32 , 33 included isolated radius or isolated ulna fractures in their studies.…”

Section: Discussionmentioning

confidence: 99%

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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

Polat¹,

Toy²

2022

AOTT

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Objective: This study aimed to compare functional and radiographical outcomes following intramedullary nailing (IMN) versus plate and screw osteosynthesis in managing patients with diaphyseal forearm fractures. Methods: Forty-six patients (27 male, 19 female) were included in this retrospective study. Of these, 25 were treated with plate osteosynthesis and 21 with IMN. The mean age was 32.4 (range, 19–67) years in the plate group and 28.8 (range, 18–64) years in the IMN group. The mean follow-up was 22.3 (range, 12–36) months in the IMN group and 24.8 (range, 12–48) months in the plate group. Functional outcomes were evaluated based on the forearm pronation/supination range of motion, grip strength, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and Grace-Eversmann scoring criteria. Results: The median time to union was 13.6 weeks in the plate group and 10.9 weeks in the IMN group (p<0.05). Union was achieved in 24 of 25 patients in the plate group (96%) and all patients in the IMN group (100%). The mean operative time was 69.7 (range, 45–110) minutes in the IMN group and 88.2 (range, 50–130) minutes in the plate group. The mean fluoroscopy time was 2.7 seconds in the plate group and 21.3 seconds in the IMN group. The mean length of hospital stay was five (range, 3–9) days in the plate group and four (range, 3–10) days in the IMN group. The mean operative time was significantly shorter in the IMN group (p < 0.05), while the mean fluoroscopy time was longer in the IMN group (p < 0.05). There was no significant difference between the groups in forearm pronation and supination, grip strength, DASH score, and Grace-Eversmann scoring criteria. Conclusion: Locked IMNs seem a viable alternative to ORIF with plate osteosynthesis for adult diaphyseal forearm fractures with similar healing rates, functional scores, and shorter operative times. Level of Evidence: Level III, Therapeutic Study

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 52%

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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

Polat¹,

Toy²

2022

AOTT

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“…An important study reporting the results of surgery using the same nail design was conducted by Kibar and Kurtulmuş. [ 17 ] In their study, the mean follow-up time was 29.8±13.2 months in the plate group and 21.6±7.6 months in the IMN group. It was reported that implant removal was not performed due to irritation in any of the patients who underwent nailing during the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, a recent study compared locking IMN with plate-screw fixation in isolated fractures of the distal third of the ulna diaphysis and, according to the Grace-Eversmann score, similar and satisfactory results were obtained in both groups: excellent/good results in 76% of the IMN group and in 86% of the plate group. [ 17 ] The time to union was reported to be a mean of 12 weeks in the IMN group and 13 weeks in the plate group. Although there was no statistically significant difference, the time to union was approximately one week shorter in the IMN group.…”

Section: Discussionmentioning

confidence: 99%

Comparison of intramedullary nailing and plate fixation in the surgical treatment of isolated fractures of the distal two-thirds of ulna diaphysis

Şişman

Polat

2023

Jt Dis Relat Surg

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Objectives This study aims to compare the clinical and radiological results of intramedullary nailing and plating, which are both techniques utilized frequently in the surgical treatment of isolated fractures of the distal third of the ulna diaphysis. Patients and methods Between January 2010 and December 2016, a total of 54 patients (34 males, 20 females; mean age: 37.8±7.4 years; range, 22 to 56 years) with isolated fractures of the distal third of the ulna diaphysis were retrospectively analyzed. The patients were divided into those treated with locking plates (Plating group, n=25) and those treated with intramedullary nailing (IMN group, n=29). The operating time and clinical and radiological results were compared between the groups. Results The median follow-up time was 93 (range, 84.5 to 99.5) months in the Pg and 86 (range, 80 to 97) months in the IMNg (p=0.179). No significant difference was observed between the groups in respect of age, sex, trauma mechanism, fracture classification, smoking status, and time from trauma to surgery. The median operating time was 46 min in the Pg and 33 min in the IMNg (p<0.001). No significant difference was found in the postoperative length of stay in hospital, reduction quality, infection rates, clinical results, radiological results, and the Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) score between the groups. Implant removal was only needed in the locking plate group (p=0.007). Conclusion In the surgical treatment of isolated fractures of the distal third of the ulna diaphysis, locked IMN seems to be a good alternative to the plate method with a shorter operating time and less need for implant removal.

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Interlocking intramedullary nail for forearm diaphyseal fractures in adults—A systematic review and meta-analysis of outcomes and complications

Lari,

Hassan,

Altammar

et al. 2024

J Orthop Traumatol

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Purpose The purpose of this systematic review is to examine the outcomes, complications, and potential advantages of using anatomical interlocking intramedullary nails (IMN) in the treatment of radius and ulnar shaft diaphyseal fractures in adults. Methods Medline, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched between January 2000 and January 2023. Studies meeting criteria were observational or randomized controlled trials evaluating outcomes in IMN for adult diaphyseal forearm fractures. Standardized data extraction was performed and a quality assessment tool was used to evaluate individual study methodology. Descriptive statistics for interventions, functional outcomes, and complications were reported. Meta-analysis was performed for patient-reported outcome measures and operative time. Results A total of 29 studies involving 1268 patients were included with 764 (60%) undergoing IMN, 21% open reduction and internal fixation (ORIF), and 9% hybrid fixation. There was no significant difference between groups in DASH and Grace–Eversmann scores. Operative time was significantly shorter in IMN compared with ORIF. The DASH scores were: 13.1 ± 6.04 for IMN, 10.17 ± 3.98 for ORIF, and 15.5 ± 0.63 in hybrids. Mean operative time was 65.3 ± 28.7 in ORIF and 50.8 ± 17.7 in IMN. Complication rates were 16.7% in the IMN group, 14.9% in ORIF, and 6.3% in hybrid constructs. There were 11 cases of extensor pollicis rupture in the IMN group. Average IMN pronation and supination were 78.3° ± 7.9° and 73° ± 5.0°, respectively. Average ORIF pronation and supination was 82.15° ± 1.9° and 79.7° ± 4.5°, respectively. Conclusions Similar functional outcomes and complication rates along with shorter operative times can be achieved with IMN compared with ORIF. The use of IMN is promising, however, higher quality evidence is required to assess appropriate indications, subtle differences in range of motion, implant-related complications, and cost-effectiveness. Trail Registration PROSPERO (International Prospective Register of Systematic Reviews) (ID: CRD42022362353). Level of evidence III.

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Treatment of adult isolated ulnar diaphyseal fractures: A comparison of new-generation locked intramedullary nail and plate fixation

Cited by 5 publications

References 16 publications

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

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

Comparison of intramedullary nailing and plate fixation in the surgical treatment of isolated fractures of the distal two-thirds of ulna diaphysis

Interlocking intramedullary nail for forearm diaphyseal fractures in adults—A systematic review and meta-analysis of outcomes and complications

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