Comparison of Locking versus Dynamic Compression Plates for Treatment of Diaphyseal Forearm Fracture

PURPOSE: To compare the clinical and radiologic outcomes of internal fixation using locking compression plate (LCP) or limited contact-dynamic compression plate (DCP) for patients with diaphyseal forearm fractures. METHODS: Forty-four patients with diaphyseal forearm fractures treated with either LCP (22 patients) or DCP (22 patients) were compared in regards to clinical outcomes, range of motion and Grace and Eversmann criteria at the last follow-up. Union rate and mean time to radiological union were also compared depending on comminution. RESULTS: Mean range of motion and Grace and Eversmann criteria between two groups did not show significant differences. Bony union was achieved in all patients. Although mean time to union was not different in simple fractures (15.5 weeks in LCP group vs. 13.8 weeks in DCP group), it was different between two groups in mutifragmentary fractures (14.8 weeks in LCP groups vs. 24 weeks in DCP group). CONCLUSION: Internal fixation using both LCP and DCP for diaphyseal forearm fractures yield satisfactory clinical and radiologic outcomes. In multifragmentary fractures, LCP can shorten radiologic union time than using DCP.

Single Bone Fixation with Flexible Intramedullary Nail for Displaced Both Forearm Bone Shaft Fractures in Children / 대한정형외과학회잡지

PURPOSE: In the present study, the usefulness of single bone flexible intramedullary nail fixation in pediatric displaced both forearm bone shaft fractures was evaluated. MATERIALS AND METHODS: From 2006, we treated 14 consecutive pediatric both forearm bone shaft fractures using a single bone flexible intramedullary fixation. The average age of patients was 8.6 years (range, 3-12 years). We nailed the one bone of the two that showed either greater deformity in the initial radiographs, or difficulty in maintaining reduction, which in our cases was usually the radius. The operation time, duration of cast removal, functional recovery and complications were evaluated. The bony alignment, maintained until bony union, was analyzed by radiographic assessment. These data were compared with 27 cases of both bone nailing, which was the standard treatment in our institution prior to 2006. RESULTS: All cases in both groups healed without secondary intervention. All cases recovered to a normal functional status after postoperative average 12 weeks. In regards to their clinical and radiographic results, there was no significant difference between the single bone fixation group and the both bone fixation group, except that there was a shorter operation time, and longer period of cast immobilization, for the single bone fixation group. CONCLUSION: Single bone flexible intramedullary fixation is a useful method for the treatment of displaced forearm bone shaft fractures in children. The strategy of fixating the bone that exhibits greater deformity or difficulty in maintaining reduction, which was usually the radius, was found to be effective in our cases.

The Internal Diameter of the Radius and Ulna in Korean Children / 대한정형외과학회잡지

PURPOSE: Flexible intramedullary nailing is a advanced method for treating forearm fractures with fewer complications. But sometimes these nails should not be used due to the narrower internal diameter of the forearm bones. We studied the inner diameter of the radius and ulna of children along with their age in relation to the width of the nail. MATERIALS AND METHODS: We reviewed the forearm AP radiographs of all the patients who visited our institute during a specific period, in which their age was between 6 and 19. We measured the inner diameters of the radius and ulna at their narrowest location, and we analyzed the diameter in relation to the patients' age groups, and we compared this data with the width for the nail. RESULTS: A total of 208 patients was included in this study. The inner diameter grew with their increasing age, and the younger the patients, the higher was the rate of inappropriate use of the nail. On linear regression analysis, the age plus or minus 1 SD for usage of the ready-made nail was 12.6 years-old for the male radius. CONCLUSION: The nail was sometimes too thick for the diameter of the forearm bones of Korean children. It is correct for the surgeon to select whatever material to fix the fracture, but appropriate thickness of the nail should be selected thoughtfully in preoperative planning.

Pediatric Forearm Bone Fractures Treated with Flexible Intramedullary Nail

PURPOSE: To determine the usefulness of flexible intramedullary fixation in pediatric forearm diaphyseal fractures. MATERIALS AND METHODS: We reviewed 22 cases of forearm diaphyseal fractures treated with flexible intramedullary nail and K-wire. The radiographic assessment was based on the time to union, maintenance of reduction and angular deformity. The functional outcome was assessed with the range of motion and complications at last follow up. RESULTS: Average length of follow up was 13.9 months with mean age of 10.8 years and the time to union was 5.2 weeks. There were no angular deformity and fuctional results were excellent in all cases. There were 5 cases of soft tissue irritation of nail insertion site as post operative complication which was resolved after nail removal. CONCLUSION: Flexible intramedullary for pediatric forearm bone fractures is an effective and safe method which gives a good functional outcome.

Reconstruction of traumatic deficiency of forearm bone: report of Two Cases / 대한정형외과학회잡지

Two cases of acquired absence of forearm bone secondary to compound comminuted fractures were treated by reconstructive surgery, which consist of surgical construction of one-bone forearm. The results of treatment were referred and the review of the literature was done concerning about surgical reconstruction of one-bone forearm.