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Comparative Studies | Orthopaedic Surgery | India | Volume 12 Issue 8, August 2023
Diaphyseal Fractures of Both Bones Forearm - A Comparative Study on Fixation Techniques and Functional Outcome between Intramedullary Nailing and Plate Osteosynthesis
Dr. Naluri Rakesh Kumar | Dr. Abhishek Sarangi [2]
Abstract: Introduction: Diaphyseal forearm fracture is one of the most commonly encountered fractures of the upper extremity. The literatures comparing the outcome of plate fixation and intramedullary nailing in adults are scarce and therefore the consensus on superiority of one over the other is lacking. This study was undertaken to compare the outcome of these operative techniques in adults with diaphyseal fracture of both bone forearm. Aim & Objectives: This study was undertaken to compare the outcome of plate fixation and intramedullary nailing in adults with diaphyseal fracture of both bone forearm. Methods: Patients of 18?70 years of age, with diaphyseal fractures of both bones of the forearm <7 days old, were selected. Patients were randomly allocated to two treatment groups: intramedullary nailing and plate osteosynthesis. Patients were followed up at 4th week, 12th week, and 24th week post-operative period. Functional outcome was measured at the end of 24th week based on Grace-Eversman Score. Result: Average time of fracture healing in our study was 8 weeks. In patients who had undergone plate osteosynthesis, it was 9 weeks whereas in patients who had undergone nail fixation it was 6 weeks. Muller?s Type 22 C3 fracture united by 11 weeks. Other fracture patterns healed between 6 and 9 weeks. Patients had restricted Pronation and supination. Three patients were treated with plate osteosynthesis and one patient with intramedullary nailing had restricted supination Pronation due to cross union.4 patients treated with plate osteosynthesis gave excellent results with regard to Pronation & supination. Patients developed post operative stiffness of elbow joint. 3 patients were treated with plate osteosynthesis and one patient with Titanium elastic nail. However, all these patients eventually had fair range of motion by the end of 12 weeks following intense physiotherapy. Our series had 90% (18 cases) of excellent /satisfactory results and 10% (2 cases) Poor results which is comparable to the previous studies. The patient who had sustained fracture of radial styloid process during titanium nail fixation following far lateral entry point developed stiffness of wrist joint. With active exercises, the ROM was increased. Restoration of Pronation & supination activities were possible by the end of 6thweek using intramedullary nailing whereas they were possible by the end of 9thweek using plate osteosynthesis.
Keywords: Both bone forearm, Diaphyseal fractures, Intramedullary nailing, Plate osteosynthesis, Internal fixation
Edition: Volume 12 Issue 8, August 2023,
Pages: 1924 - 1929