Tolga Onay, Mesut Akkaya, Mehmet Dilek, Mehmet Nuri Tütüncü, Fuat Akpınar
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引用次数: 0
Abstract
Objectives: To evaluate the effectiveness of intramedullary nailing combining with iliac or fibular autograft for the treatment of adult forearm nonunions.
Methods: Design: Retrospective case series.
Setting: Two academic trauma referral center.
Patient selection criteria: Adult patients who sustained surgical treatment for forearm fracture (OTA/AO 2R2-2U2) nonunion with intramedullary nailing and grafting from May 2005 to January 2023 were included.
Outcome measures and comparisons: The primary outcome was to determine the bone union rates after nounion surgery with intramedullary nail and grafting. Secondary outcomes were to assess functional scores including The Visual Analog Score (VAS), the shortened version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire, Grace-Eversmann evaluation criteria.
Results: The study included 24 patients comprising 19 males and 5 females (7 radius, 14 ulna, 3 both bone) with an average age at the time of surgery of 40.5 ± 11.2 years (range, 23 to 61 years) and union was achieved for 24 out of 27 bones (88.8 %) in 22 out of 24 patients. The mean (average) preoperative and postoperative QuickDASH scores were found 64.5 ± 18.2 and 15.3 ± 18.9, respectively. The functional improvement was found statistically significant (p < 0,001).The mean (average) preoperative and postoperative VAS was found to be 7.2 ± 2.1 and 1.52 ± 1.5, respectively. The difference was found statistically significant (p < 0.001). Two cases of radius nonunion healed with 10° and 15° of angulation and shortening, while nonunion persisted in two patients. All remaining cases healed without deformity. Excellent to acceptable results were obtained for 83.3% of patients according to Grace-Eversmann criteria.
Concluson: Intramedullary nailing with autologous grafting is a viable option for the treatment of adult forearm nonunions.
期刊介绍：
Journal of Orthopaedic Trauma is devoted exclusively to the diagnosis and management of hard and soft tissue trauma, including injuries to bone, muscle, ligament, and tendons, as well as spinal cord injuries. Under the guidance of a distinguished international board of editors, the journal provides the most current information on diagnostic techniques, new and improved surgical instruments and procedures, surgical implants and prosthetic devices, bioplastics and biometals; and physical therapy and rehabilitation.
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