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Abstract
BACKGROUND: The treatment goals in diaphyseal radius fractures are to regain and maintain length and rotational alignment and stability. Open reduction and plating carries the inherent problems of soft tissue disruption and periosteal stripping. Intramedullary nailing offers advantages of minimally invasive surgery and minimal soft tissue trauma. AIMS: To investigate the outcomes of locked intramedullary nailing for isolated gunshot diaphyseal radius fractures in adults. METHODS: A cross-sectional review of prospectively collected clinical and radiological data was performed. All adult patients with isolated gunshot radius fractures treated with closed reduction and locked intramedullary nailing between 2009 and 2013 were reviewed. Twenty-two nails were inserted in 22 patients, all males with a mean age of 28.9 years (range 19-40). All surgeries were performed between 2 and 12 days after injury (average 4 days). Follow-up was for an average of 11 weeks (range 8-24). RESULTS: All fractures united with the index procedure. Mean time to union was 10 weeks (range 8-24). Using the Anderson classification, the clinical outcome was excellent in 14 patients (64%), satisfactory in six (27%) and unsatisfactory in two (9%). CONCLUSION: Closed reduction and intramedullary nail fixation of gunshot radius fractures shows promising results without significant complications.
Highlights
To investigate the outcomes of locked intramedullary nailing for isolated gunshot diaphyseal radius fractures in adults
All adult patients with isolated gunshot radius fractures treated with closed reduction and locked intramedullary nailing between 2009 and 2013 were reviewed
Diaphyseal forearm fractures in adults are treated with open reduction and plate osteosynthesis with consistently good and reproducible functional outcomes
Summary
Diaphyseal forearm fractures in adults are treated with open reduction and plate osteosynthesis with consistently good and reproducible functional outcomes. This method requires more soft tissue dissection and periosteal stripping to achieve an anatomical reduction.[1] The fracture comminution and soft tissue injury seen in low velocity gunshot injuries make the technique of open reduction and plate fixation less attractive for these fractures. Closed reduction intramedullary nail fixation offers all the advantages of minimally invasive surgery with regard to preservation of biology at the fracture site.[2]. The aim of our study was to assess early clinical outcomes of closed reduction and locked intramedullary fixation of low velocity gunshot radius fractures. Intramedullary nailing offers advantages of minimally invasive surgery and minimal soft tissue trauma
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