Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail

Kwang-Yul Kim; Moon-Sup Lim; Shin-Kwon Choi; Hyeong-Jo Yoon

doi:10.12671/jkfs.2008.21.2.157

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Kim, Lim, Choi, and Yoon: Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail

Original Article

Journal of the Korean Fracture Society 2008; 21(2): 157-164.

Published online: 30 April 2008

DOI: https://doi.org/10.12671/jkfs.2008.21.2.157

Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail

Kwang-Yul Kim, M.D., Moon-Sup Lim, M.D., Shin-Kwon Choi, M.D., Hyeong-Jo Yoon, M.D.

Department of Orthopedic Surgery, Wallece Memorial Baptist Hospital, Busan, Korea.

Address reprint requests to: Kwang-Yul Kim, M.D. Department of Orthopedic Surgery, Wallece Memorial Baptist Hospital, 374-75, Namsan-dong, Geumjeong-gu, Busan 609-728, Korea. Tel: 82-51-580-1422, Fax: 82-51-583-2568, kykimdr@yahoo.co.kr

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the result of forearm shaft fracture treated by modified interlocking intramedullary nail (Acumed, Hillsbrough, IN, USA).

Materials and Methods

15 patients with fracture of radius, ulna, radio-ulna shaft treated by modified interlocking intramedullary nail from December 2003 to February 2007 were analyzed. Modified interlocking intramedullary nail has paddle blade tip and fluted rod, so the distal screw fixation was not needed but had relatively firm fixation. It has advantages including short operation time, small operation scar. The average follow up period was 8.3 months (range, 5~15 months). We analyzed the results by average union time and the functional results according to Anderson's criteria.

Results

The mean duration of union was 9.8 weeks in radius and 11.4 weeks in ulna. The average range of motion of forearm was 74.6 degree in supination and 72 degree in pronation. Functional results assessed by Anderson were rated excellet in 12 cases, satisfactory in 3 cases. We found no complications such as delayed union, non-union, neurovascular injury and infection.

Conclusion

Modified interlocking intramedullary nail (Acumed, Hillsbrough, IN, USA) is a viable therapeutic alternative in the management of forearm shaft fracture.

Keywords: Forearm shaft fracture, Modified interlocking intramedullary nail

Figures and Tables

Fig. 1

Ulna rod and Radius rod made by Acumed. A targeted interlocking screw, a paddle blade tip design, fluted rod locks and rotationally secures bone segment.

Fig. 2

(A) Forearm initial AP and lateral radiograph of 26-year-old woman shows ulnar shaft fracture after traffic accident.

(B) Postoperative 2 yrs radiograph after fixation of ulnar with modified IM nail.

(C) Last follow up AP and lateral radiograph shows complete bone union after nail removal (post op 2 yrs).

Fig. 3

(A) Radiographof 56-year-old man showing of radius shaft fracture after direct trauma.

(B) Postoperative radiograph after fixation of radius with modified IM nail.

(C) 1 year after surgery.

Fig. 4

(A) Forearm initial Radiograph of 26-year-old man shows radio-ulnar shaft fracture after traffic accident.

(B) Postoperative AP and lateral radiograph. Both forearm bone were treated with modified IM nail.

(C) 18 months after surgery.

Table 1

Functional result by Anderson

Table 2

Summary of cases

^*R: Radius, ^†U: Ulna, ^‡S: Satisfactory, ^§E: Excellent.

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