Evaluation of results of closed nailing of both bone forearm fractures

Dr Kaushlendra Kumar; Dr Arnab Sinha; Dr Ajay Kumar Mahto

Volume : VIII, Issue : VIII, August - 2019

Evaluation of results of closed nailing of both bone forearm fractures

Dr Kaushlendra Kumar, Dr Arnab Sinha, Dr Ajay Kumar Mahto

Abstract :

Forearm skeleton in humans is adapted more for mobility than stability and plays an important role in upper extremity function. The arc of Rotation is probably the most important factor for forearm. The use of intramedullary devices to stabilize fractures is not new. A study of 18 cases of diaphyseal fracture of both bones forearm fixed with intramedullary square nails was done to find out the applicability of square nails in the closed manner under C-arm control. Evaluation of the results in terms of functional outcome using the Grace and Eversman Criteria was done. 13 patients were females and 5 patients were males. 3 of the fractures were caused by direct blow, 6 were by fall on outstretched hand and 8 were due to road traffic accidents and remaining 1 was an occupational injury.14 patients had fractures on right side and 4 on left side.Short oblique fractures were the most common type of fracture in the present study.There was 1 case with superficial infection at the ulnar entry site that subsided with oral antibiotics for one week. No implant eakage or irritation due to nail or implant back-out was seen.Union was defined as the presence of idging bone or trabeculae spanning the fracture site. The patients were also evaluated clinically for fracture site tenderness and pain on rotation. The average time to union was 13 weeks (10-24 weeks).There was one case of delayed union, which subsequently showed radiographic union at 24 weeks. There was no loss of flexion or extension in any of the patients as compared to the other arm. Pronation and supination was restricted in three patients. Out of the 18, 7,7,4 and 0 patients had Excrellent, good, acceptable and unacceptable results respectively. Intramedullary nailing is a viable option for diaphyseal both bone fractures and comes with the advantages of preserving the fracture hematoma,decreased chances of infection ( as it is a closed procedure and uses the least amount of periosteal stripping) and cosmetically better. It also has lower refracture rates after implant removal.