Abstract
The purpose of this study was to evaluate the subjective and objective functional outcome after osteosynthesis of the forearm bone fractures with plates and screws (ORIF) or elastic nailing (CRIF).
We evaluated 55 patients (45 men and 10 women) who underwent internal fixation of both forearm bones with CRIF or ORIF, concerning the range of motion of the forearm, wrist and elbow (pronation, supination, flexion and extension), grip strength and a validated outcome measure (DASH score). The mean duration of follow-up was 3 years, and standardized radiographs of the forearm were evaluated. The mean age was 41.6.
We used the Student's t test to compare means and chi-square test to compare proportions.
The mean (confidence interval 95%) of the DASH scale was 29.6 (22.6 to 36.5), significantly higher (p<0.001) than the normative value in the U.S. (10.1). There was a statistically significant reduction of forearm supination (86.4 vs. 64.6, p<0.001) and grip strength (0.63 vs. 0.48, p<0.001) in relation to the opposite member; grip strength decrease correlated with worse subjective outcome (p<0.02). There were no significant differences between groups undergoing ORIF or CRIF. The risk of nonunion and reintervention was not different between groups (p=0214).
Forearm bones fractures are associated with high rates of consolidation and satisfactory mobility of the forearm since we obtain an anatomic reduction of the fracture, as is most easily achieved by plate fixation. However, elastic nailing is a less invasive technique that allows restoring function more quickly with less pain and no increased risk of complications. Given the scant scientific evidence currently available we will require a more comprehensive study to compare the anatomical and functional outcome after ORIF and CRIF.
