Study of Different Modalities of Surgical Treatment of Diaphy Seal Fractures of Forearm in Adults

Abstract

BACKGROUNDS AND OBJECTIVES: Sixty cases of fracture both bone forearm in adults were operated and fixed using various instruments in Narayana Medical College and Hospital, Nellore. The study period was June 2009 to June 2013. The case were followed up from four months to ten months. METHODS: Most of the cases were young adult male with age ranging between 17 to 73 years. The functional outcome of different modalities of surgical treatment of diaphyseal fracture of both bone forearm in adults are interpreted. We have fixed 17 patients with Dcp, 13 patients with Lcdcp, 14patients with Semitubular plating and 16 patients with Intramedullary nailing. Most cases were operated within three days of injury. Anaesthesia and Tourniquet was used for all cases. Thompsons approach was used for proximal radial fractures and Henrys approach was used for distal radial fractures. Ulna was exposed along its posterior border. Intramedullary nailing was done along radial syloid process and distal tip of olecranon in radius and ulna respectively. Closed reduction under C-arm in intramedullary procedure and open reduction and internal fixation when plating was done. Above elbow p.o.p slab were applied for all operated case. Sutures were removed at 10 th Post-operative day. Mobilization were started after suture removal in plating cases. In Intramedullary nailing cases mobilization started after clinical and radiological union. RESULTS: By Anderson Scoring System out of 14 cases of Dcp 75 %were excellent, 25% were satisfactory. Out of 11cases of Lcdcp 72.7% were excellent, 18.2% were satisfactory, 9.1% were unsatisfactory. Out of 13cases of Semitubular plating 69.2%were excellent, 23.1% were satisfactory, 7.7% were unsatisfactory. Out of 14 cases of Intramedullary nailing with Talwakar square nails 42.9% were excellent, 21.4% were satisfactory, 21.4% were unsatisfactory, 14.3%had failure results. INTERPRETATION AND CONCLUSION: Open reduction and internal fixation can be considered as the treatment of choice if there were no contraindications for this because it is important to maintain length, opposition, axial alignment and rotation alignment if a good range of movement of forearm is to be restored. This is achieved in the present study.

A Comparative Study Between Plate Osteosynthesis and Intramedullary Nailing for Diaphyseal Fracture of Radius and Ulna in Adults

“…Smaller incisions, minimal soft tissue dissection, and preservation of vascularity at the fracture site have been described as advantages of nailing over plating. Our findings are consistent with the findings of Kumar [ 19 ] and Zhang et al [ 23 ].…”

“…In our study group, men outnumbered women by a ratio of 80% to 20% in group A (nailing) and 90% to 10% in group B (plating). Our observation was in accordance with Ravi et al [ 18 ] and Kumar [ 19 ]. In our study, the right side was more common in both groups.…”

“…One patient in the nailing group had non-union who was advised for plating with bone grafting, but the patient refused. The complications of studies conducted by Kumar [ 19 ], Al-Sadek et al [ 24 ], Baldwin et al [ 25 ], and Kim et al [ 26 ] are comparable with our study. To summarize, it was discovered in our clinical study that patients in group B (plating) had fewer complications when compared to group A (nailing).…”

“…In comparison, studies conducted by Kumar [19], Moed et al [21], and Grace et al [22] found that in the majority of cases, RTA was the cause of injury, followed by assault, which is similar to our study.…”

“…Other common causes of injury included falls in 32.5% of cases and assaults in 20% of cases. In comparison, studies conducted by Kumar [ 19 ], Moed et al [ 21 ], and Grace et al [ 22 ] found that in the majority of cases, RTA was the cause of injury, followed by assault, which is similar to our study.…”