Vol 35 | Issue 2 | May-Aug 2020 | page: 19-24 | Arvind Kumar¹, Rizwan Khan¹, Dushyant Chouhan², Rajesh Arora¹, Sandeep Kumar¹, Javed Jameel¹
Authors: Arvind Kumar¹, Rizwan Khan¹, Dushyant Chouhan², Rajesh Arora¹, Sandeep Kumar¹, Javed Jameel¹
¹Department of Orthopedics, Hamdard Institute of Medical Sciences and Research,
New Delhi, India.
²Department of Orthopedics, Lady Hardinge Medical College, New Delhi, India
Address of Correspondence:
Dr. Javed Jameel,
Hamdard Institute of Medical Sciences and Research, New Delhi, India
Background: Both bone forearm fractures in adults are conventionally managed with plate fixation for both radius and ulna. The fractures involving proximal half of radial shaft need extensive muscle dissection, periosteal stripping and carry a risk of posterior interosseous nerve injury. Hybrid fixation for such fractures with titanium elastic nail system (TENs) for radial fixation and standard plating for ulnar fracture is a potentially safer alternative for these fractures. The purpose of this study is to compare the outcomes of the aforementioned hybrid fixation to conventional dual plating for adult both bone forearm fractures involving proximal half of the radial shaft.
Methods: Adult patients with both bone forearm fractures involving proximal half of the radial shaft were randomly divided into a hybrid fixation(A) and dual plating(B) groups over a two-year period. The patients were followed for a minimum of six months and radiological and functional outcomes were compared.
Results: Radiological and functional outcomes between the two groups were comparable with the exception of wrist dorsiflexion which was significantly reduced in the hybrid fixation group. The surgical duration was significantly shorter in hybrid fixation group. Loss of reduction and nail entry point pain were major complications in the hybrid fixation group. Hypertrophic radial scar and transient posterior interosseous nerve palsy were major complications in the dual plating group.
Conclusion: Hybrid fixation using plate osteosynthesis for ulnar fracture and TENs for radial fracture is a valid option for treatment of adult both bone forearm fractures involving the proximal half of radial shaft with a shorter surgical duration and less soft tissue complications when compared to open reduction and plate osteosynthesis for both the fractures.
Keywords: Adult; forearm, Fractures, Hybrid fixation, Proximal radius
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|How to Cite this Article: Kumar A, Khan R, Chouhan D, Arora R, Kumar S, Jameel J | Comparative study between hybrid fixation and dual plating in the management of both bone forearm fractures involving proximal half of radial shaft in adult patients. | Journal of Bone and Joint Diseases | May-Aug 2020;35(2):19-24.|