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Interlocking contoured intramedullary nail fixation for selected diaphyseal fractures of the forearm in adults

Cited 39 time in Web of Science Cited 47 time in Scopus
Authors
Lee, Young Ho; Lee, Sang Ki; Chung, Moon Sang; Baek, Goo Hyun; Gong, Hyun Sik; Kim, Kyung Hwan
Issue Date
2008-09-03
Publisher
Journal of Bone and Joint Surgery, Inc.
Citation
J Bone Joint Surg Am. 2008;90(9):1891-8
Keywords
*Bone NailsFracture Fixation, Intramedullary/*methodsFracture HealingHumansMaleMiddle AgedProsthesis DesignQuestionnairesRadius Fractures/radiography/*surgeryRecovery of FunctionTreatment OutcomeUlna Fractures/radiography/*surgery
Abstract
BACKGROUND: Plate osteosynthesis is the most commonly used technique for the treatment of diaphyseal forearm fractures in adults. However, application of a plate can disrupt the periosteal blood supply and necessitates skin incisions that may be unsightly, and there is a risk of refracture if the implant is removed. The purpose of this study was to assess the early results of the use of a contoured interlocking intramedullary nail to stabilize displaced diaphyseal fractures of the forearm. METHODS: Between January 2004 and July 2006, a total of thirty-eight interlocking intramedullary nails were inserted into the forearms of twenty-seven adults. Eighteen nails were used in the radius and twenty were used in the ulna to stabilize a diaphyseal fracture. The mean follow-up period was seventeen months. Functional outcomes were assessed with use of the Grace and Eversmann rating system, and patient-rated outcomes were assessed by completion of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. RESULTS: The average time to fracture union was fourteen weeks. There was one nonunion of an open comminuted fracture of the middle third of the ulna. There were no deep infections or radioulnar synostoses. According to the Grace and Eversmann rating system, twenty-two patients (81%) had an excellent result; three (11%), a good result; and two (7%), an acceptable result. The DASH scores averaged 15 points (range, 5 to 61 points). CONCLUSIONS: Our experience indicates that the advantages of an interlocking intramedullary nail system for the radius and ulna are that it is technically straightforward, it allows a high rate of osseous consolidation, and it requires less surgical exposure and operative time than does plate osteosynthesis. We suggest that the interlocking intramedullary nail system be considered as an alternative to plate osteosynthesis for selected diaphyseal fractures of the forearm in adults.
ISSN
1535-1386 (Electronic)
Language
English
URI
http://www.ejbjs.org/cgi/reprint/90/9/1891.pdf

https://hdl.handle.net/10371/67457
DOI
https://doi.org/10.2106/JBJS.G.01636
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College of Medicine/School of Medicine (의과대학/대학원)Orthopedic Surgery (정형외과학전공)Journal Papers (저널논문_정형외과학전공)
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