Study of clinicoradiological and functional outcomes of intramedullary nailing in diaphyseal radius ulna fractures in adults

Abstract

Introduction: One of the most common fractures is a forearm fracture. The most common causes of these fractures include high-energy incidents, direct trauma, and falls from great heights. It's not unusual to have open wounds with a neurovascular impairment. Supination of the forearm with a backward and upward loading force with a forward angulation while falling on an outstretched hand is comparatively a less severe mechanism than pronation and upward force. Direct impact which is referred to as ‘Nightstick injury’ also lead to shaft of ulna fracture. The goal of this study was to assess the results of closed fixation in radius ulna fractures with intramedullary nailing for a minimum of 6 months. Nailing with square nails, titanium elastic nails (TENS nails), or long Kirschner wire has proven to be extremely effective. Method: Over the course of one year, this is a retrospective case series investigation of forearm bone fractures and the treatment options available. We chose patients where intramedullary nailing was used as a therapy option and were followed for at least 6 months. Galeazzi variety, monteggia variety, pathological fracture, and non-union following previous surgery were all ruled out. Disabilities of the arm, shoulder, and hand (DASH) score and Grace and Eversmann functional outcome score were used to assess the results. Results: Of the 25 patients, 14 patients had excellent functional outcome according to Grace and Eversmann score, 8 patients had good outcome, 4 patients had acceptable while 1 was unacceptable. The mean DASH score was 16.32. Conclusion: This study shows that closed method for fixation by intramedullary nailing of both bone forearm fractures leads to excellent to good functional outcomes (according to DASH score and Grace and Eversmann score) with less complications. In 6 months follow up x ray there is radiological union in all cases with no angulation, malunion or non-union.