Journal List > Arch Hand Microsurg > v.23(1) > 1106630

Hong, Kim, Jang, and Han: Clinical Outcome of Forearm Segmental Fracture after Open Reduction and Plate Fixation

Abstract

Purpose

Forearm segmental fractures are occasionally managed by orthopedic surgeon even though the prevalence is much lower than simple fractures. However there are only a few studies dealing the treatment and results of this type of fracture in South Korea. Authors present the clinical results of forearm segmental fractures after open reduction and plate fixation.

Methods

Medical records and radiographs of 12 patients who were treated with open reduction and internal fixation for forearm segmental fracture were reviewed retrospectively. Fracture union was analyzed by serial radiographs. Clinical results were analyzed with visual analogue scale (VAS), disabilities of the arm, shoulder, and hand (DASH) score, grip strength and range of motion of relevant joints at the final follow-up.

Results

Bone union was achieved in all cases without additional procedure. The average time of bone union was 19.7 weeks. Average VAS was 2.08 and DASH score was 11.85 at the final follow-up. Average grip strength was 22.2 kg (contralateral limb 26.8 kg). Average range of motion of elbow joint was 0°–137°, and wrist flexion, extension, pronation, and supination was 65°, 74°, 84°, and 87°.

Conclusion

Authors showed satisfactory results in all cases of forearm segmental fracture. With accurate reduction and stable fixation, favorable result comparable to that of simple fracture can be achieved for complicated forearm segmental fractures.

Figures and Tables

Fig. 1

(A, B) Preoperative radiographs showing an ulna segmental fracture associated with radius distal shaft fracture. (C, D) Union of fracture sites during the follow-up.

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Fig. 2

(A–D) Forearm and wrist motion at postoperative 14 months.

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Fig. 3

(A, B) Preoperative radiographs showing a radius segmental fracture and ulna midshaft fracture. (C, D) Bony union postoperative 6 months.

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Fig. 4

(A–F) Range of motion of wrist and elbow at postoperative 12 months.

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Table 1

Demographic data of patients

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AO classification: Arbeitsgemeinschaft für Osteosynthesefragen classification.

Notes

CONFLICTS OF INTEREST The authors have nothing to disclose.

References

1. Teraa M, Blokhuis TJ, Tang L, Leenen LP. Segmental tibial fractures: an infrequent but demanding injury. Clin Orthop Relat Res. 2013; 471:2790–2796.
crossref
2. Rommens PM, Coosemans W, Broos PL. The difficult healing of segmental fractures of the tibial shaft. Arch Orthop Trauma Surg. 1989; 108:238–242.
crossref
3. Thirunarayanan V, Ramprasath DR, Rajan A. Segmental fractures of the forearm-outcome analysis of various management strategies. IOSR J Dent Med Sci. 2015; 14:13–16.
4. Matthews LS, Kaufer H, Garver DF, Sonstegard DA. The effect on supination-pronation of angular malalignment of fractures of both bones of the forearm. J Bone Joint Surg Am. 1982; 64:14–17.
crossref
5. Dumont CE, Thalmann R, Macy JC. The effect of rotational malunion of the radius and the ulna on supination and pronation. J Bone Joint Surg Br. 2002; 84:1070–1074.
crossref
6. Moss JP, Bynum DK. Diaphyseal fractures of the radius and ulna in adults. Hand Clin. 2007; 23:143–151.
crossref
7. Droll KP, Perna P, Potter J, Harniman E, Schemitsch EH, McKee MD. Outcomes following plate fixation of fractures of both bones of the forearm in adults. J Bone Joint Surg Am. 2007; 89:2619–2624.
crossref
8. Kim SB, Heo YM, Yi JW, Lee JB, Lim BG. Shaft fractures of both forearm bones: the outcomes of surgical treatment with plating only and combined plating and intramedullary nailing. Clin Orthop Surg. 2015; 7:282–290.
crossref
9. Rehman S, Sokunbi G. Intramedullary fixation of forearm fractures. Hand Clin. 2010; 26:391–401.
crossref
10. Sage FP, Smith H. Medullary fixation of forearm fractures. J Bone Joint Surg Am. 1957; 39-A:91–98.
11. Lee YH, Lee SK, Chung MS, Baek GH, Gong HS, Kim KH. Interlocking contoured intramedullary nail fixation for selected diaphyseal fractures of the forearm in adults. J Bone Joint Surg Am. 2008; 90:1891–1898.
crossref
12. Jones DJ, Henley MB, Schemitsch EH, Tencer AF. A biomechanical comparison of two methods of fixation of fractures of the forearm. J Orthop Trauma. 1995; 9:198–206.
crossref
13. Kawoosa AA, Dhar SA, Butt MF, Dar GN, Mir MR. The role of composite technique in managing peri implant re-fractures in a case with supracondylar fracture of the femur: a case report. Cases J. 2009; 2:8174.
crossref
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