A Clinical Study of Diaphyseal Fractures of the Radius and Ulna

Lim, Sin Ho; Hwang, Byung Yun; Lee, Ju Hong

Abstract

Diaphyseal fractures of the radius and ulna present high incidence of malunion and non-union because of difficulty in reduction and maintenance of two mobile, parallel bones in the presence of the pronating and supinating muscles which exert angulatory as well as rotational forces. Over the years various methods of open reduction and internal fixation or the closed method have been advocated, but open reduction, especially fixation with compression plate and screws resulted in more satisfactory results was proved recently by the major clinical reports. From March. 1977 to December. 1985, 59 cases of diaphysesl fractures of the forearm both bone in adult and children were managed in the Department of Orthopedic Surgery, Chonbuk National University Hospital and comparisions have been made between the conservative treatment group and operative group. The obtained results were as follows; 1. The most common csuse of injury was fallen on the outstretched hand in children and traffic accident in adult. 2. The most frequent site of the fracture was middle one-third(50.8%). 3. The most common pattern of the fracture was stable fracture(50.1%). 4. The applied methods for management of the fractures include cast immobilization after manual reduction or skeletal traction, K-wire fixation, compression plate and screws, intramedullary nailing, and combined. 5. Comparision of conservative treated group with operative treated group was as follows. 1) In roentgenologically, excluding those complicated by nonunion or infection, average bone union time of conservative group in children and adolescence was 10.2 weeks and in adult was 16.7 weeks, and of operative group was 13.9 weeks. 2) According to Grace and Eversmann's evaluation, Satisfactory results were shown in 80.0% of children and adolescence group treated by conservative method and 86.7% of adult group trested by compression plate and screws. 3) Among the various internal fixstion methods, compression plate and screws method was the best measure for rapid bone union and functional recovery in adult. 4) Any marked difference between each group was not seen in nonunion, but angulstory and rotational deformity were more common in conservative group and infection was developed 2 cases in operative group only. 6. There was no noticesble difference between each treatment in children and adolescence, but operative treatment, especially compression plate and screws, in adult was more superior to conservative treatment with. regard to bone union time and functional result.