DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20164005

A study on patients treated with interlock nailing in the forearm fracture bones

Shivakumar G. V., Naveen P. R., Manjunatha M. L.

Abstract


Background: Fractures involving the bones of the forearm present unique problems not encountered with fractures of other long bones and may significantly affect the function of the upper limb. The purpose of the present study was to evaluate the functional outcome of patients treated with interlock nailing in the fracture forearm bones.

Methods: Thirty two patients included after their consent. With the patient supine on a radiolucent table, and under general or regional anesthesia the extremity was prepared and the surgery was performed using a standard procedure. If secure rigid fixation is achieved forearm POP splint is applied and kept in place for 2 weeks, thereafter a removable sugar-tong orthosis is worn until bridging callus is present, and the orthosis is removed frequently for exercise.

Results: The average age of the patients was 38.90 years. The major mode of injury was RTA (59.09%) followed by assault (36.36%). 41% of patients were operated within week of injury, only three patients were operated after a week and one patient after 3 weeks. More than half of patients had closed fractures and rest was open fractures, of which Gustilo Anderson type II were in majority. In 3/5 of patients locking at nondriving end was not done cause of stable fixation. There was statistically significant difference in the surgical time (P <0.05) and duration of postoperative immobilization differed statistically significantly (P <0.001) between the group of patients in whom locking was done and not done.

Conclusions: Advantages of Interlocking nail are high rate of bony consolidation along with minimized surgical approaches, cosmetically better suited and little risk of refracture after removal of the implant.


Keywords


Forearm fracture, Interlock nailing, Gustilo Anderson type, Postoperative immobilization

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References


McFarlane AG, Macdonald LT. Parameters of the ulnar medullary canal for locked intramedullary nailing. J Biomed Eng. 1991;13(1):74-6.

Hidaka S, Gustilo RB. Refracture of bones of the forearm after plate removal. J Bone Joint Surg Am. 1984;66:1241-3.

Schemitsch EH, Richards RR. The effect of malunion on functional outcome after plate fixation of fractures of both bones of the forearm in adults. J Bone Joint Surg (Am). 1992;74:1068-78.

Crenshaw AH, Zinar DM, Pickering RM. Intramedullary nailing of forearm fractures. Instr Course Lect. 2002;51:279-89.

Anderson LD, Sisk D, Tooms RE, Park WI III. Compression-plate fixation in acute diaphyseal fractures of the radius and ulna. J Bone Joint Surg (Am). 1975;57:287-97.

Eggers GWN, Shindler TO, Pomerat CM. Clinical significance of contact compression factors in bone surgery. Arch surg. 1951;62:467.

Dodge HS, Cady GW. Treatment of fractures of radius and ulna with compression plates. JBJS. 1942;54:1167-76.

Mih AD, Cooney WP, Idler RS, Lewallen DG. Long-term follow-up of forearm bone diaphyseal plating. Clin Orthop. 1994;299:256-8.

Bolton H, Quinlan AG. The conservative treatment of fractures of the shaft of the radius and ulna in adults. Lancet. 1952;1:700-5.

Visńa P, Beitl E, Pilnı J, Cizmár I, Vlcek M, Kalvach J, et al. Interlocking nailing of forearm fractures. Acta Chir Belg. 2008;108:333-8.

Gao H, Luo CF, Zhang CQ, Shi HP, Fan CY, Zen BF. Internal fixation of diaphyseal fractures of the forearm by interlocking intramedullary nail: short-term results in eighteen patients. J Othop Trauma. 2005;19:384-91.

Lee YH, Sage FP. Medullary fixation of fractures of the forearm. A study of the medullary canal of the radius and a report of fifty fractures of the radius treated with a prebent triangular nail. J Bone Joint Surg (Am). 1959;41:1489-516.

Klemm KW, Borner M. Interlocking nailing of complex fractures of the femur and tibia. Clin Orthop. 1986;212:89-100.

Weckbach A, Blattert TR, Weisser Ch. Interlocking nailing of forearm fractures. Arch Orthop Trauma Surg. 2006;126:309-15.