Outcome Analysis of Osteosynthesis of Complex Fractures of Both Bones of Forearm

Volume 6 | Issue 2 | May-Aug 2018 | Page: 21-28 | Darshan Kumar A. Jain, Rahul P, Aubrey Conrad, Franco.

Authors: Mahesh Suresh Kulkarni [1], Sheik Mohammad Fahim [1], Monappa Naik, Sandeep Vijayan [1], Sourab Shetty [1], Sharath K Rao [1].

[1] Department of Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Sciences Manipal, India.

Address of Correspondence
Dr. Monappa Naik Aroor,

Department of Orthopaedics,

Kasturba Medical College,

Manipal Academy of Higher Sciences Manipal, India.

Email: naikortho@gmail.com

Abstract

Background: Diaphyseal forearm fractures are virtually considered as equivalent to intra articular fractures. Open Reduction with internal fixation (ORIF) with plate Osteosynthesis has been considered as the gold standard for both bone fractures. AO ‘C’ type of the fractures are of special interest because they represent complex fractures of the both bones of the forearm which includes segmental and / or comminuted fractures in the diaphyseal region. There are not many studies in the English literature which focus upon this complex fracture management and their functional outcome. We are describing the clinical, radiological and functional outcome of complex both bone forearm diaphyseal fractures treated with ORIF with LCP Osteosynthesis in skeletally mature patients who have minimum follow up of one year.

Materials and Methods: We retrospectively reviewed adult patients who were treated for complex diaphyseal both bone forearm fractures by ORIF with LCP plate Osteosynthesis between 2006 to 2016 with minimum follow up period of one year. Skeletally immature patients, nonosteoporotic pathological fractures, intact single bone, open injuries who required soft tissue coverage, injuries with dislocations of either or both of proximal and distal joints in forearm and patients with neurovascular injuries were excluded from the study. Patients were assessed for union time, complications and functional evaluation was done by Andersons criteria and Disabilities of the arm, Shoulder and Hand (DASH) scores.

Results: Of the 24 patients who were operated 20 were available for the follow up.(16 male,4 females)with mean age of 42.35 years ( range 20 to 70 years). There were 17 bifocal 16 unifocal and 7 irregular fractures.Mean follow up was 49.1 months (Range 14 to 111months). Mean union time was 7.2 months (±4.6 months). There were, 2 nonunions 2neuroproxia. As per the Anderson criteria we had 11 excellent 6 satisfactory 1 usatisfactory and 2 as failures. Mean DASH score was 18.8 (±12.42).

Conclusion: Judicious use of LCP in complex forearm fractures with early mobilization will lead to the good functional outcome with minimal complications. But there is a tendency for the delay in fracture consolidation and union.

Key words: complex fractures; Forearm Fractures; LCP osteosynthesis; both bone fractures; AO 22 C fractures; segmental fractures; diaphyseal fractures; nonunion ; radius and ulna fractures; complex fractures

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