Functional outcome of closed diaphyseal fractures of both bone forearm in adults treated by small dynamic compression plate fixation in radius & intramedullary nail fixation in ulna

Abstract

Introduction: Both bone forearrn fractures represent approximately 10-14% of all fractures.It is advocated that these type of fracture should be treated surgically, Fixation of fracture is done by either plate or nail or both. Aims and objectives: To study and evaluate functional outcome by GE (Grace & Eversmann Rating) rating & Anderson et al. score in closed diaphyseal fractures of both bone forearm in adults treated by SDCP (Small Dynamic Compression Plate) in radius & intramedullary nail in ulna. Method and Materials: Present study included 60 patients aged 18-45yrs having fracture both bone forearm admitted in OPD and emergency at MBGH Udaipur from 1stjanuary 2017 to 31stjuly 2018 & divided in 4 groups on the basis of location of fracture site of both bones, A (both upper third), B (Both Middle Third), C (both lower third) & D (Both At Different Site). All patients were operated with intramedullary Talwalkar’s square nail in ulna & SDCP in radius. Functional outcome using GE rating and Anderson et al. score and complications were observed with 9 months clinic radiological follow up. Result: Maximum no. of patients were in group B which is 36(60%). Mean union time for was minimum for B (15.41 Wks.), maximum in A (20wks) with overall 16.25wks. Average roation arc was 140.51 (90.32% of the reference mean). In GE patients showing excellent result were overall 56.6%& maximum 70% in D, while unacceptable in 6.67%. In Anderson et al. score patients showing excellent result were 63.33% overall with maximum 80% in D, while failure in 5%. Conclusion: Fracture union time was minimum in group-B & maximum in group A(because of prolong immobilization and delayed physiotherapy).Both scoring system showed best results with variable site involvement (D) because of better stability, early mobilization & good rotation arc. Considering GE & Andrson et al. scores with overall union rates & rotation arc, SDCP in radius and square nail in ulna is a good fixation modality for fracture forearms especially I n group D.