Comparison Between Incidence of Posterior Interosseous Nerve Injury Following Volar Approach and Dorsal Approach in Fixing Fractures of Proximal Half of Radial Shaft

Abstract

BACKGROUND Open reduction and internal fixation, with plates and screws, is the preferred standard method of treatment of displaced fractures of the shaft of the forearm bones. Proximal half of shaft of radius can be approached either by volar (anterior) or dorsal (posterior) approach. Posterior Interosseous Nerve (PIN) injury is a common complication of both the approaches. The aim of this study was to compare incidence of Posterior Interosseous Nerve (PIN) injury following any one of the approaches used for open reduction and internal fixation (ORIF) of fractures involving proximal half of shaft of the radius. METHODS This prospective randomised study was conducted from July 2015 to June 2017, at Department. of Orthopaedics, Calcutta National Medical College and Hospital. Open reduction and internal fixation was done on fifty (50) patients, who presented with fracture of proximal half of radial shaft, with 3.5 mm Limited Contact Dynamic Compression Plate (LCDCP) or 3.5 mm Dynamic Compression Plate (DCP) and corresponding screws. Volar approach was done on twenty-five patients and in the rest, dorsal approach was used. Comparison of PIN Palsy in each approach was the primary concern. RESULTS PIN palsy occurred in 2 patients of VA (volar approach) and 3 patients of DA (dorsal approach). Two patients in each group had infection, which resolved to conservative methods and one patient of VA group and 2 patients in DA group had non-union.