Management of Radius and / Or Ulna Fracture by Screw Intramedullary Nail in Skeletally Mature Patients

Dr. Parth Shah, Dr. Nareshkumar Dhaniwala, Dr. Poornima Pandey
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Abstract

The standard nailing of both bone forearm fractures of the radius and ulna poses a possible complication of nail migration androtational instability, despite being one of the best reduction techniques. This study has strived to evaluate how effectively screw elasticintramedullary nail is useful in the therapy for mature diaphyseal fractures of both bone forearms. The issues faced with conventional nailingtechniques for managing forearm fractures have also been discussed. A prospective evaluation of twenty-one cases with forearm fractures (radiusand ulna or isolated fracture of the single bone) was done. Out of the twenty-one cases studied, eighteen patients had undergone closedreduction, and three cases required mini-open reduction. The fracture was categorized as claimed by Arbeitsgemeinschaft furOsteosynthesefragen (AO) Foundation/Orthopedic Trauma Association(OTA). The results were evaluated according to Anderson criteria, inwhich 13 cases had excellent results, 4 had good results, 3 had an unsatisfactory result, and 1 was reported as failure. Also, there was 1 case ofsynostosis and 1 case of delayed union in radius. We concluded that the intramedullary screw nail for forearm fractures in adults could be used asa good internal fixation therapy giving excellent functional and radiological results. This technique is easy to learn, and the implant used is alsocost-effective, thus, providing a good fixation of the fracture. The most accepted technique for forearm fracture, as per current recommendationand AO, are open reductions and internal fixation with plating, but our study is exclusive since it helped to overcome the failure of conventionalnailing of both forearm bones with the potential complication of nail migration and rotational instability in spite the best reduction.
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骨成熟患者桡骨和/或尺骨骨折的髓内钉治疗
桡骨和尺骨前臂骨折的标准钉入虽然是最好的复位技术之一,但可能会造成钉移位和旋转不稳定的并发症。本研究旨在评估弹性髓内钉在治疗前臂双侧成熟骨干骨折中的有效性。我们也讨论了传统的前臂骨折固定技术所面临的问题。对21例前臂骨折(桡骨、尺骨或孤立性单骨骨折)进行了前瞻性评估。在研究的21例病例中,18例患者接受了闭合复位,3例需要小切口复位。骨折被Arbeitsgemeinschaft furrosteosynthesefragen (AO)基金会/骨科创伤协会(OTA)分类。按照Anderson标准对结果进行评价,其中优13例,良4例,不理想3例,不合格1例。桡骨愈合延迟1例,骨膜粘连1例。我们认为髓内钉治疗成人前臂骨折是一种良好的内固定治疗方法,具有良好的功能和放射学效果。该技术易于学习,所使用的植入物也具有成本效益,因此可以很好地固定骨折。根据目前的推荐和AO,最被接受的前臂骨折技术是切开复位和钢板内固定,但我们的研究是排他的,因为它有助于克服传统的前臂骨钉入失败,尽管有最好的复位,但钉子移位和旋转不稳定的潜在并发症。
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