Surgical outcomes of segmental diaphyseal forearm fractures in adults: a small case series on plate osteosynthesis, intramedullary nailing, and other surgical methods

BMC Musculoskeletal Disorders

Research

Sung Yoon Jung¹  Hyo Seok Jang²  Tae Young Ahn³  Sang Hyun Lee³  Sang Ho Kwak⁴  Dong Hee Kim⁵  Jong Min Jeon⁵ 

[1] Department of Orthopedic Surgery, College of Medicine, Dong-A University Hospital, Busan, Republic of Korea;Department of Orthopedic Surgery, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea;Department of Orthopedic Surgery, Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea;Department of Orthopedic Surgery, SNU Seoul Hospital, Seoul, Republic of Korea;Departments of Orthopedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea;

关键词: Segmental;    Diaphyseal;    Forearm;    Fracture;   

DOI  :  10.1186/s12891-023-06857-1

 received in 2023-03-31, accepted in 2023-09-06,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSegmental fractures often result from high-energy or indirect trauma that causes bending or torsional forces with axial loading. We evaluated surgical outcomes of patients with forearm segmental diaphyseal fractures.MethodsWe retrospectively analyzed data from patients with forearm segmental fractures for which they underwent surgery at the Pusan National University Trauma Center from March 2013 to March 2022. We also analyzed accompanying injuries, injury severity score (ISS), injury mechanism, occurrence of open fracture, surgical technique, and treatment results.ResultsFifteen patients were identified, one with bilateral segmental diaphyseal forearm bone fracture, for a total of 16 cases. Nine of the patients were male. The overall mean age was 50 years, and the mean follow-up period was 16.2 months. Six cases who underwent surgery using plate osteosynthesis achieved bone union without length deformity at final follow-up. Three of seven patients who underwent intramedullary nailing alone underwent reoperation due to nonunion. Six cases achieved bone union at final follow-up, three of which showed length deformity. Three patients underwent surgery using a hybrid method of IM nailing, plates, and mini cables. One patient who underwent surgery with a plate and one patient who underwent surgery with IM nailing alone showed nonunion and were lost to follow-up.ConclusionPlate osteosynthesis is considered the gold standard for treatment of adult forearm diaphyseal segmental fractures. In this study, IM nailing was associated with high rates of non-union and length deformity. However, the combination of IM nailing and a plate-cable system may be an acceptable alternative in segmental diaphyseal forearm fracture, achieving a union rate similar to that provided by plate fixation.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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