Removal of forearm plates. A review of the complications

Langkamer, V.G.; Ackroyd, C. E.

doi:10.1302/0301-620x.72b4.2380210

Cited by 106 publications

(51 citation statements)

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“…36 There were no refractures in our series. At the final review, 23 patients had their plate removed, seven within nine months of the initial operation.…”

Section: Discussionmentioning

confidence: 53%

“…20,35 Rates of complication of 10% to 30% have been reported. 35,36 Removal of the plates may also be associated with significant complications. Scarring from the previous surgery and bone growth over the plates may make their removal difficult.…”

Section: Discussionmentioning

confidence: 99%

“…Scarring from the previous surgery and bone growth over the plates may make their removal difficult. 21,23,36,37 There are recent reports of good results obtained with intramedullary fixation. 16 devices in only one bone is associated with loss of reduction and some authors recommend stabilisation of both bones.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of unstable fractures of the forearm in children

Bhaskar

Roberts

2001

The Journal of Bone and Joint Surgery. British volume

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U nstable fractures of the forearm in children present problems in management and in the indications for operative treatment. In children, unlike adults, the fractures nearly always unite, and up to 10° of angulation is usually considered to be acceptable. If surgical intervention is required the usual practice in the UK is to plate both bones as in an adult. We studied, retrospectively, 32 unstable fractures of the forearm in children treated by compression plating. Group A (20 children) had conventional plating of both forearm bones and group B (12 children) had plating of the ulna only. The mean age was 11 years in both groups and 23 (71%) of the fractures were in the midshaft. In group B an acceptable position of the radius was regarded as less than 10° of angulation in both anteroposterior (AP) and lateral planes, and with the bone ends hitched. This was achieved by closed means in all except two cases, which were therefore included in group A.Union was achieved in all patients, the mean time being 9.8 weeks in group A and 11.5 weeks in B. After a mean interval of at least 12 months, 14 children in group A and nine in group B had their fixation devices removed.We analysed the results after the initial operation in all 32 children. The 23 who had the plate removed were assessed at final review. The results were graded on the ability to undertake physical activities and an objective assessment of loss of rotation of the forearm.In group A, complications were noted in eight patients (40%) after fixation and in six (42%) in relation to removal of the radial plate. No complications occurred in group B.The final range of movement and radiological appearance were compared in the two groups. There was a greater loss of pronation than supination in both. There was, however, no limitation of function in any patient and no difference in the degree of rotational loss between the two groups. The mean radiological angulation in both was less than 10° in both AP and lateral views, which was consistent with satisfactory function. The final outcome for 23 patients was excellent or good in 12 of 14 (90%) in group A, despite the complications, and in eight of nine in group B (90%).If reduction and fixation of the fracture of the ulna alone restores acceptable alignment of the radius in unstable fractures of the forearm, operation on the radius can be avoided. Compression plating is widely accepted as the appropriate treatment for fractures of the forearm in adults in order to reduce the incidence of nonunion, malunion and subsequent loss of function.1-3 In children, a similar approach is usually unnecessary since healing of the fractures is rarely a problem and anatomical realignment is not required because of the remodelling potential of the immature skeleton. [4][5][6][7] The ability to remodel decreases with increasing age, and over ten years it is less predictable and less effective. [8][9][10] In children the correlation between malunion and function is poor, but residual angulation of more than 10° should probably be co...

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“…36 There were no refractures in our series. At the final review, 23 patients had their plate removed, seven within nine months of the initial operation.…”

Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of unstable fractures of the forearm in children

Bhaskar

Roberts

2001

The Journal of Bone and Joint Surgery. British volume

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“…Wound complication and refracture rates are high after plate removal. 7,8,11 The insertion point pain after tibial nailing is recently reported in literature, but its etiology is unclear. Insertion point pain appears to be secondary to tendon or muscle impingement in our study as it improved in the majority of cases following removal of the nail.…”

Section: Discussionmentioning

confidence: 99%

“…Very few literature is available on intramedullary nail removal and its complications on the other hand several literature exists on removal of plates. [6][7][8] Some literature have shown improvement in symptoms after nail removal ,while some literature contradicts this and states that pain might persist even after the nail removal or pain can be a new symptom. 9,10 In order to assess the indication, complications and morbidity of tibia nail removal, we retrospectively reviewed a series of tibial nail removed in our institution.…”

Section: Introductionmentioning

confidence: 99%