Abstract
Background: In the current era of industrialization and with mechanized farming in India, fractures of forearm bones have become more common. The forearm serves an important role in the functioning of the upper extremity. Hence aggressive management through good anatomical reduction and internal fixation of these fractures has become a necessity. The purpose of this study was to assess and compare functional results of plating and nailing in fracture stabilization. Methods: Retrospective and prospective study with the sample size of 20 patients with both bone forearm fractures. 10 patients were treated with dynamic compression plating and remaining 10 with intramedullary square nails. Results were assessed by time for union, type of fractures, range of motion of elbow and wrist joint, complications and functional assessment were done by Grace- Eversmann Criteria and DASH questionnaire. Results were statistically analysed with Mann- Whitney U-test. Results: Out of 20 cases 18 were males and 2 females, with average age of 38.5 years. 12 fractures were of A32 type according to AO classification. Good or full range of mobility of elbow and wrist joints with excellent & satisfactory results were present in 16 patients as per Grace-Eversmann criteria. 2 patients showed ulnar nail back out while other 2 had delayed union of fracture, all seen with intramedullary nailing. Conclusion: There was no statistically significant difference between results of nailing and plating. However, it is concluded that while good functional results can be obtained with intramedullary nailing of forearm fractures, open reduction and internal fixation offracture remains the treatment of choice for most forearm fractures with adherence to AO principles.
Highlights
The incidence of diaphyseal fractures of the radius, ulna or both is reported to be approximately 1 to 10 per 10,000 persons per year, rates may vary according to age and sex
With rigid/anatomical internal fixation, adherence to AO principles dynamic compression plate is a good fixation for displaced diaphyseal fractures of the forearm bones
Intramedullary nailing of these fractures appears to be technically more challenging and requires more intraoperative radiation than plating and external immobalization is required
Summary
The incidence of diaphyseal fractures of the radius, ulna or both is reported to be approximately 1 to 10 per 10,000 persons per year, rates may vary according to age and sex. Studies show a bimodal distribution, with the highest incidence among young males aged 10 to 20 years (10:10,000) and females over age 60years (5:10,000)[1,2,3] In this era of active life, rapid industrialisation, increasing road traffic accidents, competitive sports; the incidence of fractures of forearm bones are increasing in frequency[4]. Results were assessed by time for union, type of fractures, range of motion of elbow and wrist joint, complications and functional assessment were done by Grace- Eversmann Criteria and DASH questionnaire. It is concluded that while good functional results can be obtained with intramedullary nailing of forearm fractures, open reduction and internal fixation offracture remains the treatment of choice for most forearm fractures with adherence to AO principles
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