FOREARM FRACTURE TABLE FOR CLOSED NAILING OF FRACTURES OF SHAFTS OF FOREARM BONES IN ADULTS

Background: Fractures involving the bones of the forearm present unique problems not encountered with fractures of other long bones and may significantly affect the function of the upper limb. The purpose of the present study was to evaluate the functional outcome of patients treated with interlock nailing in the fracture forearm bones.Methods: Thirty two patients included after their consent. With the patient supine on a radiolucent table, and under general or regional anesthesia the extremity was prepared and the surgery was performed using a standard procedure. If secure rigid fixation is achieved forearm POP splint is applied and kept in place for 2 weeks, thereafter a removable sugar-tong orthosis is worn until bridging callus is present, and the orthosis is removed frequently for exercise.Results: The average age of the patients was 38.90 years. The major mode of injury was RTA (59.09%) followed by assault (36.36%). 41% of patients were operated within week of injury, only three patients were operated after a week and one patient after 3 weeks. More than half of patients had closed fractures and rest was open fractures, of which Gustilo Anderson type II were in majority. In 3/5 of patients locking at nondriving end was not done cause of stable fixation. There was statistically significant difference in the surgical time (P <0.05) and duration of postoperative immobilization differed statistically significantly (P <0.001) between the group of patients in whom locking was done and not done. Conclusions: Advantages of Interlocking nail are high rate of bony consolidation along with minimized surgical approaches, cosmetically better suited and little risk of refracture after removal of the implant.

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Elastic stable intramedullary nailing in pediatric diaphyseal forearm bone fracture

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20170455 ◽

2017 ◽

Vol 3 (2) ◽

pp. 190

Author(s):

Poojan Kumar Rokaya ◽

Mangal Rawal ◽

Javed Ahmad Khan ◽

Praveen Kumar Giri

Keyword(s):

Intramedullary Nailing ◽

Bone Fracture ◽

Closed Reduction ◽

Forearm Fracture ◽

Minimal Invasive ◽

Elastic Stable Intramedullary Nailing ◽

Forearm Bones ◽

Average Loss ◽

Forearm Bone ◽

Elastic Intramedullary Nailing

Background: Pediatric forearm bone fracture present significant challenges where most of them are managed with closed reduction and casting. Irreducible, unstable and open fracture usually requires operative stabilization. Intramedullary nailing is considered minimal invasive however it is not free of complication. The aim of this study is to analyze the outcome and complications after elastic stable intramedullary nailing in pediatric diaphyseal forearm fracture.Methods: A descriptive observational study was carried out for four years (2013-2016) in diaphyseal pediatric forearm fracture stabilized with titanium elastic stable intramedullary nailing. Final range of motion, complications and outcome were assessed using Clavien-Dindo classification modification appropriate for orthopedic surgery.Results: We report the outcome of 36 patients with complete medical records. Closed reduction and nailing was successful in 25 patients (69.4%) whereas eleven patients (30.6%) required open reduction (both radius and ulna in 6 patients 16.7%, ulna in 3 patients 8.3% and radius in 2 patients 5.6%). Radiological union was achieved at an average of 7.75±1.5 weeks (range 6 to 16 weeks). Forearm rotation was limited in 7 patients with average loss of 16° pronation and 18° supination. The overall rate of complication was 22.2%. According to Clavien-Dindo classification excellent results were noted in 29 patients (80.6%), good in 3 patients (8.3%) and fair in 4 patients (11.1%). Conclusions: Elastic intramedullary nailing in pediatric diaphyseal forearm bones fracture is minimally invasive with low rate of complication and the outcomes are fair to excellent.

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Repair of an open forearm fracture and extensive bony loss (case report)

Genij Ortopedii ◽

10.18019/1028-4427-2021-27-1-87-91 ◽

2021 ◽

Vol 27 (1) ◽

pp. 87-91

Author(s):

Sh.M. Davirov ◽

◽

P.U. Urinboev ◽

Keyword(s):

High Risk ◽

Intramedullary Nailing ◽

Forearm Fracture ◽

Complete Recovery ◽

Bony Defect ◽

Fibular Graft ◽

Comminuted Fracture ◽

Soft Tissue Necrosis ◽

Ilizarov Frame ◽

Forearm Bones

Introduction Repair of a double open comminuted fracture of forearm bones with extensive bony loss is challenging due to a high risk of infection and the need to address a significant bony defect. Neither internal fixation nor open reduction could be considered due to substantial bone loss and severely impaired circulation with a high risk of soft tissue necrosis and infection. We report staged management of forearm fracture using avascular autologous graft to repair the defect and maintain the forearm length. Objective Demonstrate the successful management of the double open comminuted fracture of forearm bones with extensive bony loss using Ilizarov external fixation, classical autologous grafting harvested from fibula and intramedullary (IM) nailing. Results and discussion The limb was temporarily fixed with Ilizarov frame in an extra-focal manner. An autogenous fibular graft of 11 cm was used to fill in the gap. Intramedullary nailing of the radius and ulna was produced and ulnar defect was repaired with autogenous fibular graft. IM nails were removed once the bones consolidated. The limb function was completely regained, anatomical length of the segment maintained and metal constructs removed. Conclusion Combination of different bone fixation modalities, classical autografting technique and intramedullary nailing provided complete recovery of the broken limb maintaining the function and bringing down the risk of complications to ensure a good clinical result.

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Elastic intramedullary nail treatment of adolescent perihardware radius and ulna refracture

BMJ Case Reports ◽

10.1136/bcr-2020-236098 ◽

2021 ◽

Vol 14 (1) ◽

pp. e236098

Author(s):

Carah M Griffin ◽

Jeremy S Somerson

Keyword(s):

Intramedullary Nailing ◽

Intramedullary Nail ◽

Plate Fixation ◽

Forearm Fracture ◽

Entire Length ◽

Hardware Removal ◽

Intramedullary Nails ◽

Flexible Intramedullary Nailing ◽

Additional Protection ◽

Forearm Bones

A 13-year-old girl presented to the clinic with a midshaft refracture of both forearm bones adjacent to the site of a prior forearm fracture that had been treated with plating. She was treated with hardware removal and placement of elastic intramedullary nails. Flexible intramedullary nailing can be successful for a skeletally mature adolescent in treatment of refracture surrounding plate fixation of a midshaft forearm fracture. This technique allows for additional protection of the entire length of the affected bones, while avoiding the extensive dissection needed for extended plating.

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The T2 intramedullary compression tibia nailing: Comparison of fracture table and manual traction, a prospective multicenter international clinical study

Zentralblatt für Chirurgie - Zeitschrift für Allgemeine Viszeral- Thorax- und Gefäßchirurgie ◽

10.1055/s-0031-1289009 ◽

2011 ◽

Vol 136 (05) ◽

Author(s):

R Jairam ◽

JP Stahl ◽

P de Lucas ◽

K Westermann

Keyword(s):

Clinical Study ◽

Fracture Table ◽

Manual Traction

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X-ray Follow-up after Open Reduction Internal Fixation of Distal Forearm Fracture

Journal of Wrist Surgery ◽

10.1055/s-0040-1721139 ◽

2020 ◽

Author(s):

Henrik Johan Sjølander ◽

Sune Jauffred ◽

Michael Brix ◽

Per H. Gundtoft

Keyword(s):

Diagnostic Imaging ◽

Forearm Fracture ◽

Minimal Risk ◽

Distal Forearm ◽

Forearm Fractures ◽

Distal Forearm Fracture ◽

Standard Regimen ◽

Prolonged Immobilization ◽

Distal Forearm Fractures

Abstract Background Following surgery, the standard regimen for fractures of the distal forearm includes radiographs taken 2-weeks postoperatively. However, it is unclear whether these radiographs have any therapeutic risks or benefits for patients. Objective The purpose of this study is to determine the importance of radiographs taken 2-weeks after surgery on distal forearm fractures, especially if it leads to further operations, and to establish whether this practice should be continued. Materials and Methods This is a retrospective cohort study of patients with a distal forearm fracture treated surgically with a volar locking plate at two university hospitals in Denmark. Standard aftercare at both departments is 2 weeks in a cast. Patients attend a 2-week follow-up, at which the cast is replaced with a removable orthosis and radiographs are taken. It was recorded whether these radiographs had resulted in any change of treatment in terms of further operations, prolonged immobilization, additional clinical follow-up, or additional diagnostic imaging. Results A total of 613 patients were included in the study. The radiographs led to a change of standard treatment for 3.1% of the patients. A second operation was required by 1.0%; 0.5% were treated with prolonged immobilization, and 1.6% had additional outpatient follow-up due to the findings on the radiographs. Additional diagnostic imaging was performed on 1.9% of the patients. Conclusion The radiographs taken at the 2-weeks follow-up resulted in a change of treatment in 3.1% of the cases. Given the low cost and minimal risk of radiographs of an extremity, we concluded that the benefits outweigh the costs of routine radiographs taken 2 weeks after surgical treatment of distal forearm fractures.

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