title: Internal fixation of diaphyseal fractures of the forearm:  a retrospective comparison of hybrid fixation versus dual plating.
abstract: OBJECTIVE
  To compare open reduction and internal fixation using dual plating to a hybrid fixation construct with intramedullary nailing of the ulna and plate fixation of the radius in both-bone forearm fractures.
  
  
  METHODS
  Retrospective comparison study.
  
  
  METHODS
  Level I trauma center.
  
  
  METHODS
  A total of 56 skeletally mature individuals treated surgically for acute both-bone forearm fractures between July 2005 and December 2009. Monteggia, Galeazzi, and pathologic fractures, patients treated with external fixation and patients with traumatic brain injuries were excluded.
  
  
  METHODS
  Twenty-seven patients were treated with dual plate fixation, and 29 patients were treated using a hybrid fixation construct.
  
  
  METHODS
  Time to union, range of motion as assessed using a Grace and Eversmann score, and presence of complications.
  
  
  RESULTS
  There was no significant difference in either time to union or Grace and Eversmann scores between the 2 groups. There was 1 nonunion in each of the 2 groups. Nine overall complications, outside nonunions, were reported: 5 in the dual plating group and 4 in the hybrid fixation group.
  
  
  CONCLUSIONS
  Hybrid fixation, using open reduction and internal fixation with a plate-and-screw construct on the radius and closed--or minimally open--reduction and interlocked intramedullary fixation of the ulna, is an acceptable method for treating both-bone diaphyseal forearm fractures in skeletally mature patients.
  
  
  METHODS
  Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery, Harbor-UCLA Medical Center, Torrance, CA 90509, USA. nmbehnke@gmail.com
authors.forename: Nicole M K
authors.initials: NM
authors.lastname: Behnke
authors.forename: Hamid R
authors.initials: HR
authors.lastname: Redjal
authors.forename: Virginia T
authors.initials: VT
authors.lastname: Nguyen
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Zinar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D002648:Child; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000601:surgery*; D011885:Radius Fractures / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000175:diagnosis / Q000601:surgery*; D055815:Young Adult