Comparison between locked intramedullary nailing and plate osteosynthesis in the management of adult forearm fractures

We evaluated the results of two different surgical methods for the treatment of adult diaphyseal fractures of both forearm bones. Forty-two adult patients with forearm fractures were retrospectively evaluated. Of these, 22 patients (7 women, 15 men; mean age 32 years; range 18 to 69 years) underwent open reduction and plate-screw fixation, and 20 patients (6 women, 14 men; mean age 33 years; range 18 to 70 years) underwent closed reduction and locked intramedullary nail fixation. The fractures were classified according to the AO/OTA system. The patients were assessed using the Grace-Eversmann criteria and the DASH (Disability of the Arm, Shoulder and Hand) questionnaire. The mean follow-up was 30 months (range 12 to 45) with plate-screw fixation, and 23 months (range 12 to 34) with intramedullary nailing. The mean operation time was 65 minutes (range 40 to 97 min) with plate-screw fixation, and 61 minutes (range 35 to 90 min) with intramedullary nailing (p>0.05). The mean time to union was significantly shorter with intramedullary nailing (10 weeks vs. 14 weeks; p0.05). Postoperative complications were seen in three patients (13.6%) and two patients (10%) with plate-screw fixation and intramedullary nailing, respectively. The two fixation methods yield similar results in terms of functional healing and patient satisfaction in the management of adult forearm fractures.