The effects of radial bowing and complications in intramedullary nail fixation of adult forearm fractures

Yörükoğlu, Ali Çağdaş

doi:10.5606/ehc.2017.05

Cited by 9 publications

(5 citation statements)

References 14 publications

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“…Notably, 11 instances of EPL ruptures were linked to IMN, necessitating reoperations for extensor pollicis longus reconstructions and tendon transfers, primarily diagnosed 2–6 weeks post-surgery. These injuries were often traced back to an ulnar entry point violating the third extensor compartment and creating bony spurs from Lister’s tubercle [ 12 , 18 , 28 ]. Thus, proper visualization, a more radial entry point, and hardware that is not prominent may mitigate this risk [ 12 , 17 , 18 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…These injuries were often traced back to an ulnar entry point violating the third extensor compartment and creating bony spurs from Lister’s tubercle [ 12 , 18 , 28 ]. Thus, proper visualization, a more radial entry point, and hardware that is not prominent may mitigate this risk [ 12 , 17 , 18 , 28 ]. Nerve palsies, impacting roughly 1% of IMN cases, were treated conservatively, though their precise cause remains elusive in most studies [ 10 , 14 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

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Interlocking intramedullary nail for forearm diaphyseal fractures in adults—A systematic review and meta-analysis of outcomes and complications

Lari,

Hassan,

Altammar

et al. 2024

J Orthop Traumatol

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Purpose The purpose of this systematic review is to examine the outcomes, complications, and potential advantages of using anatomical interlocking intramedullary nails (IMN) in the treatment of radius and ulnar shaft diaphyseal fractures in adults. Methods Medline, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched between January 2000 and January 2023. Studies meeting criteria were observational or randomized controlled trials evaluating outcomes in IMN for adult diaphyseal forearm fractures. Standardized data extraction was performed and a quality assessment tool was used to evaluate individual study methodology. Descriptive statistics for interventions, functional outcomes, and complications were reported. Meta-analysis was performed for patient-reported outcome measures and operative time. Results A total of 29 studies involving 1268 patients were included with 764 (60%) undergoing IMN, 21% open reduction and internal fixation (ORIF), and 9% hybrid fixation. There was no significant difference between groups in DASH and Grace–Eversmann scores. Operative time was significantly shorter in IMN compared with ORIF. The DASH scores were: 13.1 ± 6.04 for IMN, 10.17 ± 3.98 for ORIF, and 15.5 ± 0.63 in hybrids. Mean operative time was 65.3 ± 28.7 in ORIF and 50.8 ± 17.7 in IMN. Complication rates were 16.7% in the IMN group, 14.9% in ORIF, and 6.3% in hybrid constructs. There were 11 cases of extensor pollicis rupture in the IMN group. Average IMN pronation and supination were 78.3° ± 7.9° and 73° ± 5.0°, respectively. Average ORIF pronation and supination was 82.15° ± 1.9° and 79.7° ± 4.5°, respectively. Conclusions Similar functional outcomes and complication rates along with shorter operative times can be achieved with IMN compared with ORIF. The use of IMN is promising, however, higher quality evidence is required to assess appropriate indications, subtle differences in range of motion, implant-related complications, and cost-effectiveness. Trail Registration PROSPERO (International Prospective Register of Systematic Reviews) (ID: CRD42022362353). Level of evidence III.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Interlocking intramedullary nail for forearm diaphyseal fractures in adults—A systematic review and meta-analysis of outcomes and complications

Lari,

Hassan,

Altammar

et al. 2024

J Orthop Traumatol

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“…Although the incidence of the fractures of the forearm is generally low in adults, these fractures could result in considerable disability if the native forearm geometry is not restored [1][2][3] .There are some intramedullary nails that provide control of rotational malalignment at the fracture line but their usage is vulnerable to complications and internal fixation with the plate is still considered as the gold standard [4][5][6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Kilitli Kompresyon Plağı ile Tedavi Edilmiş Erişkin Önkol Kırıklarının Sonuçlarını Etkileyen Faktörler

Utkan

Koçak²,

Ceritoğlu³

et al. 2018

İstanbul Gelişim Üniversitesi Sağlık Bilimleri Dergisi

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Aim: Although internal fixation of forearm fractures by dynamic compression plates had been studied extensively, the details of optimal fixation by locking compression plates are not clearly defined. Besides the factors affecting the functional outcome is still the subject of considerable debate. The present study is designed to evaluate factors affecting the outcomes of adult forearm fractures treated via locking compression plate. Method: The patients with Gustillo Anderson type 3 open fractures or the ones treated in intensive care unit were excluded and thirty-six forearm fractures treated by locking compression plate were prospectively followed. Disability Arm Shoulder Hand (DASH) and Anderson criteria scores for assessment of outcomes obtained at sixth month were evaluated. The patients were followed up for 4 (3-6) years on average. Findings: In 18 (50%) patients, fractures were caused by simple fall. The mean healing time of the fractures was 13.2 ± 2.1 weeks. Patients, who smoked or had open fractures or complications, had longer healing time. Mean DASH score was calculated as 13.9 ± 5.9. Upon Özgün Araştırma Makalesi (Original Research Article) Geliş /

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“…also demonstrated high risk of synostosis when intramedullary nail was used for the treatment [10]. Hematoma caused by reaming, if located at damaged interosseous membranes, may result in radioulnar synostoses too.…”

mentioning

confidence: 99%

“…Radial bowing could not be anatomically restored by radius nail too. Too much malreduction of radial bowing may result in nonunion [10].…”

mentioning

confidence: 99%

Intramedullary nail fixation for the treatment of simple forearm fractures in military combatants

Wang¹,

Zheng²,

He³

et al. 2020

Preprint

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Background: Most of forearm fracture in military combatants are simple fracture. The traditational procedure for adult forearm fracture is open reduction and plate osteosynthesis. However, plate fixation do have the defect of nonunion, stress shielding, skin irritation. Intramedullary nail is believed to be an alternative treatment of adult forearm fractures. However, whether simple forearm fractures in military combatants could be successfully treated by intramedullary nail is not clear.Methods: Patients of military combatants with diagnosis of simple forearm fracture treated by intramedullary nail fixation were identified from 1st January 2016 to 31st November 2018 in this retrospective study. General information of the patients, time of follow-up, time of fracture union post-operation, complications, rotation activity and DASH score 12 month post-operation were recorded to figure out the clinical outcome of simple forearm fracture treated by intramedullary nail in military combatants.Outcome: Twenty male patients were identified in this retrospective study, with average age of 26.5 years old (range 18-36).Fourteen forearm fracture happened in right side and the rest six happened in left side. Single ulna fracture happened in 11 cases, single radius fracture happened in 4 cases , both forearm fracture happened in 5 cases. Classifications of the 20 patients were all OTA type A. All 20 patients got followed, with mean follow-up time of 15.8 months（range 12-18). All patients got fracture union successfully. Average time of fracture union was 2.6 months（range 2-4months）. Partially rupture of extensor pollicis longus tendon happened during operation in one patient and 3 months post-operation in another patient. One patient with both forearm fractures showed linear ossification of interosseous membranes. Average pronation activity 12 months post-operation was 86.9 degrees (range 80-90), average supination activity 12 months post-operation was 86.3 degrees (range 60-90). Average DASH score 12 months post-operation was 6.5（range 0-37).Conclusion: This respective study demonstrated that intramedullary nail achieved excellent results in the treatment of simple fracture of forearm in military combatants.Trial Registration : Not applicable

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The effects of radial bowing and complications in intramedullary nail fixation of adult forearm fractures

Cited by 9 publications

References 14 publications

Interlocking intramedullary nail for forearm diaphyseal fractures in adults—A systematic review and meta-analysis of outcomes and complications

Interlocking intramedullary nail for forearm diaphyseal fractures in adults—A systematic review and meta-analysis of outcomes and complications

Kilitli Kompresyon Plağı ile Tedavi Edilmiş Erişkin Önkol Kırıklarının Sonuçlarını Etkileyen Faktörler

Intramedullary nail fixation for the treatment of simple forearm fractures in military combatants

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