T1.3 Treatment of pediatric unstable forearm fractures with intramedullary Kirschner wires

Abstract

Introduction: The treatment goal for diaphyseal single and both bone fractures in adults is to restoration of bone length, provide axial and rotational stability, and to secure fixation that allows early mobilization. Intramedullary (iM) nails are not routinely used in the surgical treatment of forearm fractures. However, this trend has started to change with the newly designed interlocking iM nails. We evaluated a new iM nails for treating forearm diaphyseal fractures in adults. Materials and Methods: We retrospectively reviewed adults with single and both bone fractures, who were treated with a new iM radius and ulna nails between May 2008 and May 2011 and who were followed for a least 1 year. Patients with a Galeazzi fracture, a pathological fracture or patients with nonunion after previous surgeries were excluded. All patients were allowed full range of motion without any external support. The results were evaluated according to Grace–Eversmann and DASH scores. Results: The 61 enrolled patients (mean age, 37 years; 32 men) had 83 forearm fractures: 23 isolated radius fractures, 18 isolated ulna fractures (2 bilateral), and 40 fractures of both the radius and ulna. Mean time to fracture union was 13 weeks (range, 10 to 14 weeks) for ulnar fractures and 12 weeks (range, 10 to 13 weeks) for radial fractures. No patient had non-union, deep infections, or radioulnar synostosis. Followup ranged from12 to 38months. Grace–Eversmann ratingswere excellent in 53 patients, good in 5,medium in 2 and poor in 1. Mean DASH score was 6.5 points (range, 0 to 13.3). Conclusion: The new intramedullary nail systemsmay be considered as a good alternative to both classical intramedullary nails and plate osteosynthesis in adult forearm diaphyseal fractures. The advantages are short operative time, insertion by closed and minimal invasive techniques mostly, the use of a minimally scope, smaller operative scar and sufficient stability in all planes that allows early motion without additional support. T1.2 Acromioclavicular reconstruction using hook plate and anterior tibial tendon allograft with triple tunnel: can it be considered as an alternative surgical technique? A. Deveci1, A. Firat2, S. Yilmaz1, K.O. Unal1, H.I. Acar3, A.O. Yildirim1, M. Bozkurt4. 1Ankara Numune Education and Research Hospital, 2Ankara Kecioren Education and Research Hospital, 3Ankara University Department of Anatomy, 4Ankara Ataturk Education and Research Hospital, Ankara, Turkey