The purpose of this study was to investigate patient-based functional outcome and objectively measure strength following plate fixation of fractures of both bones of the forearm. Twenty-five subjects were clinically and radiographically reviewed. Strength of elbow flexion, extension, supination, pronation, wrist flex-ion, extension and grip were significantly reduced in the injured arm. (p< 0.01, range 62%–84% of normal). Mean (+/− SE) DASH score was 19.5 +/− 4.0 and eighty-eight percent (22/25) scored good to excellent on the Gartland-Werley scale (mean 4.04 +/− 0.91). No statistical difference in mean maximal radial bow (MRB) or location of MRB between injured and non-injured arm was found.

The purpose of this study was to investigate functional outcome and objectively measure strength following plate fixation of fractures of both bones of the forearm (BBOF).

Anatomic reduction was associated with good to excellent functional outcome. However strength of the elbow, forearm, wrist and grip were significantly reduced in the injured arm.

Despite good to excellent functional outcome following this injury, significant reduction in strength of the upper extremity should be expected, and thus is an area for potential improvement in post-operative care.

Twenty-five subjects (M/F 19/6, mean age 47.6 (range 20–71)) treated with plate fixation for fractures of BBOF were clinically and radiographically reviewed. Mean duration of follow-up was 5.7 years (range 2–13.4 y). Post-operative protocol included short-term immobilization followed by active-assisted ROM and strengthening starting between four and six weeks. Isometric muscle strength was objectively measured with the Baltimore Therapeutic Equipment work simulator (model WS-20). Strength of elbow flexion (72% of non-injured arm, p< 0.0001), elbow extension (84%, p=0.0004), forearm supination (75%, p=0.005), forearm pronation (69%, p< 0.0001), wrist flexion (81%, p=0.009), wrist extension (62%, p< 0.0001) and grip (70%, p< 0.0001) were all significantly reduced in the injured arm. Mean (+/− SE) DASH and Gartland-Werley scores were 19.5 +/− 4.0 (range 0–61) and 4.04 +/− 0.91 (range 0–15) respectively. Eighty-eight percent (22/25) scored good to excellent on the Gartland-Werley scale. No statistical difference in mean maximal radial bow (MRB) between injured and non-injured arm was found (mean +/− SE, 1.42 +/− 0.07 vs 1.58 +/− 0.05 respectively) or in location of MRB (61% vs 59%).

Introduction and Aims: Patient-based functional outcome and strength following plate fixation of diaphyseal fractures of the radius and ulna is unknown. Therefore, the purpose of this study was to investigate patient-based functional outcome and objectively measured strength following plate fixation of fractures of both bones of the forearm (BBOF).

Method: Twenty-five subjects (M/F 19/6, mean age 47.6 (range 20–71) treated with plate fixation for fractures of BBOF were clinically and radiographically reviewed. Mean duration of follow-up was 5.7 years (range 2–13.4 years). Post-operative protocol included short-term immobilisation followed by active-assisted ROM and strengthening starting between four and six weeks. All subjects were assessed in person at follow-up with a detailed examination of strength of their injured and non-injured arms. Isometric muscle strength was objectively measured with the Baltimore Therapeutic Equipment work simulator (model WS-20). Standardised anteroposterior and lateral radiographs were made of both forearms.

Results: Strength of elbow flexion (72% of non-injured arm, p< 0.0001), elbow extension (84%, p=0.0004), forearm supination (75%, p=0.005), forearm pronation (69%, p< 0.0001), wrist flexion (81%, p=0.009), wrist extension (62%, p< 0.0001) and grip (70%, p< 0.0001) were all significantly reduced in the injured arm. Mean (+/− SE) DASH and Gartland-Werley scores were 19.5 +/− 4.0 (range 0–61) and 4.04 +/− 0.91 (range 0–15) respectively. Eighty-eight percent (22/25) scored good to excellent on the Gartland-Werley scale. No statistical difference in mean maximal radial bow (MRB) between injured and non-injured arm was found (mean +/− SE, 1.42 +/− 0.07 vs 1.58 +/− 0.05 respectively) or in location of MRB (61% vs 59%).

Conclusion: Restoration of anatomic alignment with stable internal fixation following BBOF fracture results in good to excellent functional outcome. Despite this, significant reduction in strength of the elbow, forearm, wrist and grip should be expected following this injury, and is an area for potential improvement in post-operative care.