Surgical outcomes of segmental diaphyseal forearm fractures in adults: a small case series on plate osteosynthesis, intramedullary nailing, and other surgical methods
Abstract Background Segmental fractures often result from high-energy or indirect trauma that causes bending or torsional forces with axial loading. We evaluated surgical outcomes of patients with forearm segmental diaphyseal fractures. Methods We retrospectively analyzed data from patients with for...
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-023-06857-1 |
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| author | Dong Hee Kim Hyo Seok Jang Sang Ho Kwak Sung Yoon Jung Jong Min Jeon Tae Young Ahn Sang Hyun Lee |
| author_facet | Dong Hee Kim Hyo Seok Jang Sang Ho Kwak Sung Yoon Jung Jong Min Jeon Tae Young Ahn Sang Hyun Lee |
| author_sort | Dong Hee Kim |
| collection | DOAJ |
| description | Abstract Background Segmental fractures often result from high-energy or indirect trauma that causes bending or torsional forces with axial loading. We evaluated surgical outcomes of patients with forearm segmental diaphyseal fractures. Methods We retrospectively analyzed data from patients with forearm segmental fractures for which they underwent surgery at the Pusan National University Trauma Center from March 2013 to March 2022. We also analyzed accompanying injuries, injury severity score (ISS), injury mechanism, occurrence of open fracture, surgical technique, and treatment results. Results Fifteen patients were identified, one with bilateral segmental diaphyseal forearm bone fracture, for a total of 16 cases. Nine of the patients were male. The overall mean age was 50 years, and the mean follow-up period was 16.2 months. Six cases who underwent surgery using plate osteosynthesis achieved bone union without length deformity at final follow-up. Three of seven patients who underwent intramedullary nailing alone underwent reoperation due to nonunion. Six cases achieved bone union at final follow-up, three of which showed length deformity. Three patients underwent surgery using a hybrid method of IM nailing, plates, and mini cables. One patient who underwent surgery with a plate and one patient who underwent surgery with IM nailing alone showed nonunion and were lost to follow-up. Conclusion Plate osteosynthesis is considered the gold standard for treatment of adult forearm diaphyseal segmental fractures. In this study, IM nailing was associated with high rates of non-union and length deformity. However, the combination of IM nailing and a plate-cable system may be an acceptable alternative in segmental diaphyseal forearm fracture, achieving a union rate similar to that provided by plate fixation. |
| first_indexed | 2024-03-10T22:24:57Z |
| format | Article |
| id | doaj.art-3174f5ca4bf143148dc9568483bbb420 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-10T22:24:57Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-3174f5ca4bf143148dc9568483bbb4202023-11-19T12:09:06ZengBMCBMC Musculoskeletal Disorders1471-24742023-09-0124111010.1186/s12891-023-06857-1Surgical outcomes of segmental diaphyseal forearm fractures in adults: a small case series on plate osteosynthesis, intramedullary nailing, and other surgical methodsDong Hee Kim0Hyo Seok Jang1Sang Ho Kwak2Sung Yoon Jung3Jong Min Jeon4Tae Young Ahn5Sang Hyun Lee6Departments of Orthopedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of MedicineDepartment of Orthopedic Surgery, Inje University Haeundae Paik Hospital, Inje University College of MedicineDepartment of Orthopedic Surgery, SNU Seoul HospitalDepartment of Orthopedic Surgery, College of Medicine, Dong-A University HospitalDepartments of Orthopedic Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of MedicineDepartment of Orthopedic Surgery, Medical Research Institute, Pusan National University Hospital, Pusan National University School of MedicineDepartment of Orthopedic Surgery, Medical Research Institute, Pusan National University Hospital, Pusan National University School of MedicineAbstract Background Segmental fractures often result from high-energy or indirect trauma that causes bending or torsional forces with axial loading. We evaluated surgical outcomes of patients with forearm segmental diaphyseal fractures. Methods We retrospectively analyzed data from patients with forearm segmental fractures for which they underwent surgery at the Pusan National University Trauma Center from March 2013 to March 2022. We also analyzed accompanying injuries, injury severity score (ISS), injury mechanism, occurrence of open fracture, surgical technique, and treatment results. Results Fifteen patients were identified, one with bilateral segmental diaphyseal forearm bone fracture, for a total of 16 cases. Nine of the patients were male. The overall mean age was 50 years, and the mean follow-up period was 16.2 months. Six cases who underwent surgery using plate osteosynthesis achieved bone union without length deformity at final follow-up. Three of seven patients who underwent intramedullary nailing alone underwent reoperation due to nonunion. Six cases achieved bone union at final follow-up, three of which showed length deformity. Three patients underwent surgery using a hybrid method of IM nailing, plates, and mini cables. One patient who underwent surgery with a plate and one patient who underwent surgery with IM nailing alone showed nonunion and were lost to follow-up. Conclusion Plate osteosynthesis is considered the gold standard for treatment of adult forearm diaphyseal segmental fractures. In this study, IM nailing was associated with high rates of non-union and length deformity. However, the combination of IM nailing and a plate-cable system may be an acceptable alternative in segmental diaphyseal forearm fracture, achieving a union rate similar to that provided by plate fixation.https://doi.org/10.1186/s12891-023-06857-1SegmentalDiaphysealForearmFracture |
| spellingShingle | Dong Hee Kim Hyo Seok Jang Sang Ho Kwak Sung Yoon Jung Jong Min Jeon Tae Young Ahn Sang Hyun Lee Surgical outcomes of segmental diaphyseal forearm fractures in adults: a small case series on plate osteosynthesis, intramedullary nailing, and other surgical methods BMC Musculoskeletal Disorders Segmental Diaphyseal Forearm Fracture |
| title | Surgical outcomes of segmental diaphyseal forearm fractures in adults: a small case series on plate osteosynthesis, intramedullary nailing, and other surgical methods |
| title_full | Surgical outcomes of segmental diaphyseal forearm fractures in adults: a small case series on plate osteosynthesis, intramedullary nailing, and other surgical methods |
| title_fullStr | Surgical outcomes of segmental diaphyseal forearm fractures in adults: a small case series on plate osteosynthesis, intramedullary nailing, and other surgical methods |
| title_full_unstemmed | Surgical outcomes of segmental diaphyseal forearm fractures in adults: a small case series on plate osteosynthesis, intramedullary nailing, and other surgical methods |
| title_short | Surgical outcomes of segmental diaphyseal forearm fractures in adults: a small case series on plate osteosynthesis, intramedullary nailing, and other surgical methods |
| title_sort | surgical outcomes of segmental diaphyseal forearm fractures in adults a small case series on plate osteosynthesis intramedullary nailing and other surgical methods |
| topic | Segmental Diaphyseal Forearm Fracture |
| url | https://doi.org/10.1186/s12891-023-06857-1 |
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