Neglected Forearm Fractures and Its Outcome Following Mediolateral Plate Osteosynthesis: A Retrospective Case Series
Background: Displaced both bone forearm injuries are essential fractures for fixation. It is not uncommon in certain parts of developing countries for indigenous bone setters to extend their misguided treatment that results in nonunion or malunion of these fractures. The masterly neglect by the pati...
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Jaypee Brothers Medical Publisher
2024-06-01
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| Series: | Journal of Orthopedics and Joint Surgery |
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| Online Access: | https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1145 |
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| author | Sitsabesan Chokkalingam Ashok T Ramanathan Gopinath Menon |
| author_facet | Sitsabesan Chokkalingam Ashok T Ramanathan Gopinath Menon |
| author_sort | Sitsabesan Chokkalingam |
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| description | Background: Displaced both bone forearm injuries are essential fractures for fixation. It is not uncommon in certain parts of developing countries for indigenous bone setters to extend their misguided treatment that results in nonunion or malunion of these fractures. The masterly neglect by the patients and the lawful mismanagement by the bone setters cause additional stiffness of the adjacent joints and affect the forearm rotational functions even in the absence of neurovascular compromise.
Aim: To assess the clinical and radiological outcome of neglected bone forearm fractures treated with delayed surgical fixation by medial ulnar and lateral radius (MEULAR) plate fixation technique.
Materials and methods: The retrospective series includes 11 cases of neglected forearm diaphyseal fractures from January 2019 to November 2022. The mean age in this study group is 32.4 years, with an average time delay of 3.8 months in presentation for the definitive procedure. In these cases, fixation was done using a dynamic compression or locking plate on the medial side of the ulna and lateral side of the radius after open fibroosteoclysis. Both functional and radiological outcomes were assessed with minimum follow-up till the fracture union. Anderson's criteria was used for functional assessment and radiological assessment of radius using bow magnitude, bow percentage and bow ratio.
Results: Fracture healing was achieved in all our cases. Functional results were excellent in nine cases and satisfactory in two cases with extended rehabilitation. Restoration of radial bow and interosseous space was feasible with delayed plate osteosynthesis.
Conclusion: Delayed fixation in neglected forearm fractures with the MEULAR concept achieves fracture healing with good to excellent functional outcomes. Despite the operative complexity of open osteoclasis or the need for bone grafting, the anatomical radial bow can be restored in the absence of forearm cross-union. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2024-06-01 |
| publisher | Jaypee Brothers Medical Publisher |
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| series | Journal of Orthopedics and Joint Surgery |
| spelling | doaj-art-4ed372b4d4e84979a3bd8eb29c844d632025-02-07T11:18:35ZengJaypee Brothers Medical PublisherJournal of Orthopedics and Joint Surgery2582-78632024-06-016216116610.5005/jojs-10079-114515Neglected Forearm Fractures and Its Outcome Following Mediolateral Plate Osteosynthesis: A Retrospective Case SeriesSitsabesan Chokkalingam0https://orcid.org/0000-0003-1657-2751Ashok T Ramanathan1https://orcid.org/0000-0003-0330-4387Gopinath Menon2https://orcid.org/0000-0001-5964-2399Department of Orthopedics, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, India, Phone: +91 9710495064Department of Orthopedics, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, IndiaDepartment of Orthopedics, Sri Ramachandra Medical College and Research Institute, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), Chennai, Tamil Nadu, IndiaBackground: Displaced both bone forearm injuries are essential fractures for fixation. It is not uncommon in certain parts of developing countries for indigenous bone setters to extend their misguided treatment that results in nonunion or malunion of these fractures. The masterly neglect by the patients and the lawful mismanagement by the bone setters cause additional stiffness of the adjacent joints and affect the forearm rotational functions even in the absence of neurovascular compromise. Aim: To assess the clinical and radiological outcome of neglected bone forearm fractures treated with delayed surgical fixation by medial ulnar and lateral radius (MEULAR) plate fixation technique. Materials and methods: The retrospective series includes 11 cases of neglected forearm diaphyseal fractures from January 2019 to November 2022. The mean age in this study group is 32.4 years, with an average time delay of 3.8 months in presentation for the definitive procedure. In these cases, fixation was done using a dynamic compression or locking plate on the medial side of the ulna and lateral side of the radius after open fibroosteoclysis. Both functional and radiological outcomes were assessed with minimum follow-up till the fracture union. Anderson's criteria was used for functional assessment and radiological assessment of radius using bow magnitude, bow percentage and bow ratio. Results: Fracture healing was achieved in all our cases. Functional results were excellent in nine cases and satisfactory in two cases with extended rehabilitation. Restoration of radial bow and interosseous space was feasible with delayed plate osteosynthesis. Conclusion: Delayed fixation in neglected forearm fractures with the MEULAR concept achieves fracture healing with good to excellent functional outcomes. Despite the operative complexity of open osteoclasis or the need for bone grafting, the anatomical radial bow can be restored in the absence of forearm cross-union.https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1145forearm fracture nonunion(medial ulnar and lateral radius concept) medial ulnarneglected forearm fracturesradius bow restorationlateral radius plating |
| spellingShingle | Sitsabesan Chokkalingam Ashok T Ramanathan Gopinath Menon Neglected Forearm Fractures and Its Outcome Following Mediolateral Plate Osteosynthesis: A Retrospective Case Series Journal of Orthopedics and Joint Surgery forearm fracture nonunion (medial ulnar and lateral radius concept) medial ulnar neglected forearm fractures radius bow restoration lateral radius plating |
| title | Neglected Forearm Fractures and Its Outcome Following Mediolateral Plate Osteosynthesis: A Retrospective Case Series |
| title_full | Neglected Forearm Fractures and Its Outcome Following Mediolateral Plate Osteosynthesis: A Retrospective Case Series |
| title_fullStr | Neglected Forearm Fractures and Its Outcome Following Mediolateral Plate Osteosynthesis: A Retrospective Case Series |
| title_full_unstemmed | Neglected Forearm Fractures and Its Outcome Following Mediolateral Plate Osteosynthesis: A Retrospective Case Series |
| title_short | Neglected Forearm Fractures and Its Outcome Following Mediolateral Plate Osteosynthesis: A Retrospective Case Series |
| title_sort | neglected forearm fractures and its outcome following mediolateral plate osteosynthesis a retrospective case series |
| topic | forearm fracture nonunion (medial ulnar and lateral radius concept) medial ulnar neglected forearm fractures radius bow restoration lateral radius plating |
| url | https://www.jojs.in/doi/JOJS/pdf/10.5005/jojs-10079-1145 |
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