JOMPAC
Journal of Medicine and Palliative Care

Journal of Medicine and Palliative Care (JOMPAC) is an open access scientific journal with independent, unbiased, and double-blind review under international guidelines. The purpose of JOMPAC is to contribute to the literature by publishing articles on health sciences and medicine.

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Original Article
Comparison of clinical and functional outcomes of patients who underwent plate osteosynthesis and intramedullary nailing for forearm fractures
Abstract
Aims: The aim of this study was to compare the functional and radiographic results of patients with forearm diaphyseal fractures after intramedullary nailing (IMN) and plate and screw osteosynthesis.
Methods: A total of 58 patients, including 31 patients operated on with the plate osteosynthesis method and 27 patients operated on with the IMN method for forearm diaphyseal fractures between 2017 and 2022, were retrospectively analyzed. The mean age was 35.9±14.5 years in the plate group and 33±13.1 years in the IMN group. The mean follow-up period was 157±83 days in the IMN group and 220±97 days in the plate group. Evaluation criteria for functional outcomes were forearm pronation; supination range of motion; the Disabilities of the Arm, Shoulder, and Hand (DASH) score; and the Grace-Eversmann score.
Results: The mean union time was 66.7 days in the plate group and 54.4 days in the IMN group (p=0.039). The mean length of hospitalization was 3.9±3.44 days in the plate group and 2.93±1.49 days in the IMN group. The mean supination range was 72.5±9.9 degrees in the plate group and 72.2±11.8 degrees in the IMN group. The mean pronation range was 81.2±11.7 degrees in the plate group and 80.3±15.5 degrees in the IMN group. The mean follow-up period was 157±83 days in the IMN group and 220±97 days in the plate group (p=0.011). According to the Association for Osteosynthesis/Orthopedic Trauma Association (AO/OTA) classification, 30 cases were classified as type A, 21 cases as type B, and 7 cases as type C. According to the Grace-Eversmann classification, 2 cases in the plate group were classified as unacceptable, 2 were classified as acceptable, 10 were classified as good, and 16 were classified as excellent, while 2 cases in the IMN group were classified as unacceptable, 4 were classified as acceptable, 5 were classified as good, and 16 were classified as excellent. The mean DASH score was 14.74±10.49 in the plate group and 15.11±12.7 in the IMN group.
Conclusion: With the advantages of minimal incision, less soft tissue damage, and no evacuation of the fracture hematoma, the union time and follow-up periods were found to be shorter in the IMN group. Thanks to the bearing force of intracanal intramedullary nails, patients were able to move earlier and satisfactory functional outcomes were obtained.

Keywords : Forearm fracture, intramedullary nailing, plate osteosynthesis, ulna fracture, radius fracture

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1. Orbay JL, Cambo RA. Biomechanical factors in stability of theforearm. Hand Clin. 2020;36(4):407-415. doi: 10.1016/j.hcl.2020.06.001
2. LaStayo PC, Lee MJ. The forearm complex: anatomy,biomechanics and clinical considerations. J Hand Ther.2006;19(2):137-144. doi: 10.1197/j.jht.2006.02.002
3. Soubeyrand M, Assabah B, Bégin M, Laemmel E, Dos SantosA, Crézé M. Pronation and supination of the hand: anatomyand biomechanics. Hand Surg Rehabil. 2017;36(1):2-11. doi:10.1016/j.hansur.2016.09.012
4. Hong DY, Berube ER, Strauch RJ. Non-operative management ofadult both bone forearm fractures - a case report and literaturereview. J Orthop Case Rep. 2020;10(7):53-56. doi: 10.13107/jocr.2020.v10.i07.1916
5. Dodge HS, Cady GW. Treatment of fractures of the radius andulna with compression plates. J Bone Joint Surg Am. 1972;54(6):1167-1176.
6. Blazevic D, Bencic I, Cuti T, et al. Intramedullary nailing of adultforearm fractures: results and complications. Injury. 2021;52(Supplement 5):S44-S48. doi: 10.1016/j.injury.2020.11.012
7. Gadegone W, Salphale YS, Lokhande V. Screw elasticintramedullary nail for the management of adult forearmfractures. Indian J Orthop. 2012;46(1):65-70. doi: 10.4103/0019-5413.91637
8. Schulte LM, Meals CG, Neviaser RJ. Management of adultdiaphyseal both-bone forearm fractures. J Am Acad Orthop Surg.2014;22(7):437-446. doi: 10.5435/JAAOS-22-07-437
9. Köse A, Aydın A, Ezirmik N, Topal M, Can CE, Yılar S.Intramedullary nailing of adult isolated diaphyseal radius fractures.Ulus Travma Acil Cerr Derg. 2016;22(2):184-191.
10. Köse A, Aydın A, Ezirmik N, Can CE, Topal M, Tipi T. Alternativetreatment of forearm double fractures: new design intramedullarynail. Arch Orthop Trauma Surg. 2014;134(10):1387-1396. doi:10.1007/s00402-014-2058-9
11. Saka G, Saglam N, Kurtulmus T, et al. Treatment of isolateddiaphyseal fractures of the radius with an intramedullary nail inadults. Eur J Orthop Surg Traumatol. 2014;24(7):1085-1093.
12. Ozkaya U, Kiliç A, Ozdoğan U, Beng K, Kabukçuoğlu Y.Comparison between locked intramedullary nailing and plateosteosynthesis in the management of adult forearm fractures.Acta Orthop Traumatol Turc. 2009;43(1):14-20. doi: 10.3944/AOTT.2009.014
13. Kibar B, Kurtulmuş T. Comparison of new design lockedintramedullary nails and plate osteosynthesis in adult isolateddiaphyseal radius fractures. Eur J Trauma Emerg Surg. 2020;46(6):1429-1435. doi: 10.1007/s00068-019-01131-3
14. Meinberg EG, Agel J, Roberts CS, Karam MD, Kellam JF. Fractureand dislocation classification compendium-2018. J OrthopTrauma. 2018;32:S1-S10. doi: 10.1097/BOT.0000000000001063
15. Gustilo RB, Anderson JT. Prevention of infection in the treatmentof one thousand and twenty-five open fractures of long bones:retrospective and prospective analyses. J Bone Joint Surg Am.1976;58(4):453-458.
16. Hudak PL, Amadio PC, Bombardier C. Development of anupper extremity outcome measure: the DASH (disabilities ofthe arm, shoulder and hand). Am J Ind Med. 1996;29(6):602-608. doi: 10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L
17. Grace TG, Eversmann WW. Forearm fractures: treatment by rigidfixation with early motion. J Bone Joint Surg Am. 1980;62(3):433-438.
18. Polat O, Toy S. Comparison of the clinical and radiographicoutcomes of plate fixation versus new-generation lockedintramedullary nail in the management of adult forearmdiaphyseal fractures. Acta Orthop Traumatol Turc.2022;56(5):321-326. doi: 10.5152/j.aott.2022.21190
19. Savajiyani D, Chauhan N, Ramavat S. The outcomes of intra-medullary square nail for adult both bone forearm shaft fractures.J Orthop Spine Trauma. 2023;9(3):125-128. doi: 10.18502/jost.v9i3.13021
20. Visna P, Vlcek M, Valcha M, Beitl E, Jaganjac E, Smídl Z.Management of diaphyseal forearm fractures using LCP angle-stable fixation devices and intramedullary nailing. Rozhl Chir.2009;88(12):708-715.
21. Weckbach A, Blattert TR, Weisser C. Interlocking nailing offorearm fractures. Arch Orthop Trauma Surg. 2006;126(5):309-315. doi: 10.1007/s00402-006-0122-9
22. Lee SK, Kim KJ, Lee JW, Choy WS. Plate osteosynthesis versusintramedullary nailing for both forearm bones fractures. EurJ Orthop Surg Traumatol. 2014;24(5):769-776. doi: 10.1007/s00590-013-1242-x
23. Saka G, Saglam N, Kurtulmuş T, et al. New interlockingintramedullary radius and ulna nails for treating forearmdiaphyseal fractures in adults: a retrospective study. Injury.2014;45(Supplement 1):S16-S23. doi: 10.1016/j.injury.2013.10.040
24. Gao H, Luo CF, Zhang CQ, Shi HP, Fan CY, Zen BF. Internal fixationof diaphyseal fractures of the forearm by interlocking intramedullarynail: short-term results in eighteen patients. J Orthop Trauma.2005;19(6):384-391. doi: 10.1097/01.bot.0000157911.76433.db
Article available in :
Volume 5, Issue 1, 2024
Page : 65-71
https://doi.org/10.47582/jompac.1421368
Article Information
Submitted : 17 Oca 2024
Accepted : 21 Şub 2024
Corresponding Author :

Okan Ateş: Deparment of Orthopedic and Traumatology, Bower Hospital, Diyarbakır, Turkiye

[email protected]
Citation : Ateş O, Altıntaş M. Comparison of clinical and functional outcomes of patients who underwent plate osteosynthesis and intramedullary nailing for forearm fractures. J Med Palliat Care. 2024;5(1):65-71.

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