[Comparison between locked intramedullary nailing and plate osteosynthesis in the management of adult forearm fractures].
OBJECTIVE
We evaluated the results of two different surgical methods for the treatment of adult diaphyseal fractures of both forearm bones.


METHODS
Forty-two adult patients with forearm fractures were retrospectively evaluated. Of these, 22 patients (7 women, 15 men; mean age 32 years; range 18 to 69 years) underwent open reduction and plate-screw fixation, and 20 patients (6 women, 14 men; mean age 33 years; range 18 to 70 years) underwent closed reduction and locked intramedullary nail fixation. The fractures were classified according to the AO/OTA system. The patients were assessed using the Grace-Eversmann criteria and the DASH (Disability of the Arm, Shoulder and Hand) questionnaire. The mean follow-up was 30 months (range 12 to 45) with plate-screw fixation, and 23 months (range 12 to 34) with intramedullary nailing.


RESULTS
The mean operation time was 65 minutes (range 40 to 97 min) with plate-screw fixation, and 61 minutes (range 35 to 90 min) with intramedullary nailing (p>0.05). The mean time to union was significantly shorter with intramedullary nailing (10 weeks vs. 14 weeks; p<0.05). According to the Grace-Eversmann criteria, the results were excellent or good in 18 patients (81.8%) and acceptable in four patients (18.2%) treated with plate-screw fixation, compared to 18 patients (90%) and two patients (10%), respectively, treated with intramedullary nailing. The mean DASH scores were 15 (range 4 to 30) and 13 (range 3 to 25), respectively. The two groups did not differ significantly with respect to functional results and DASH scores (p>0.05). Postoperative complications were seen in three patients (13.6%) and two patients (10%) with plate-screw fixation and intramedullary nailing, respectively.


CONCLUSIONS
The two fixation methods yield similar results in terms of functional healing and patient satisfaction in the management of adult forearm fractures.
Ozkaya
Ufuk
U
Taksim Eğitim ve Araştirma Hastanesi Ortpoedi ve Travmatoloji Kliniği), Istanbul, Turkey. ufukozkaya2004@yahoo.com
Kiliç
Ayhan
A
Ozdoğan
Umit
U
Beng
Kubilay
K
Kabukçuoğlu
Yavuz
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D001858:Bone Nails; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000601:surgery*; D055815:Young Adult