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International Journal of Orthopaedics Sciences 2017; 3(1): 97-108
ISSN: 2395-1958
IJOS 2017; 3(1): 97-108
© 2017 IJOS
www.orthopaper.com
Received: 18-11-2016
Accepted: 19-12-2016
Vishwanath C
Senior Resident, Department of
Orthopaedics, Adichunchangiri
Institute of Medical Sciences,
B G Nagar, Mandya, Karnataka,
India
Satheesh GS
Assistant Professor, Department
of Orthopaedics,
Adichunchangiri Institute of
Medical Sciences,
B G Nagar, Mandya, Karnataka,
India
Saumitra Dwivedi
Post Graduate, Department of
Orthopaedics, Adichunchangiri
Institute of Medical Sciences,
B G Nagar, Mandya, Karnataka,
India
Manash Jyoti Baruah
Post Graduate, Department of
Orthopaedics, Adichunchangiri
Institute of Medical Sciences,
B G Nagar, Mandya, Karnataka,
India
Correspondence
Vishwanath C
Senior resident, Department of
Orthopaedics, Adichunchangiri
Institute of Medical Sciences,
B G Nagar, Mandya, Karnataka,
India
Surgical management of fracture both bones forearm
in adults using LC-DCP
Vishwanath C, Satheesh GS, Saumitra Dwivedi and Manash Baruah
DOI: http://dx.doi.org/10.22271/ortho.2017.v3.i1b.18
Abstract
Background: Fractures of both bone of the forearm are relatively common injuries which can challenge
the treating orthopaedican. Healing occurs reliably after closed treatment but malunion, with resultant
decreased rotation of the forearm is common and has been associated with poor results
[1]
. Rotation of the
forearm is a complex interaction between the radius and ulna and restoration of this movement depends
on both on accurate reduction of fractures, this is achieved by ORIF using LC-DCP.
[3]
The “Limited Contact Dynamic Compression Plate”, was developed by Perren S. M. et to release the new
concept of biological internal fixation. Grooves on the undersurface of the LC-DCP improved blood
circulation. There is decreased damage to contact between plate and bone. It also allows for a small bone
bridge beneath the plate at the most critical area, which is otherwise weak due to a stress concentration
effect. In addition, there is more even distribution of the plate than in conventional plates. This study is
undertaken to assess the results of diaphyseal fractures of BBFA using LCDCP to study the advantages
and its complications.
Materials and Methods: Patients who are admitted in Adichunchanagiri Institute of Medical Sciences
are taken for study after obtaining their consent. This is prospective study from May 2013 to May 2016.
Results: This study consists of 50 cases of fracture Both Bone Forearm Fractures. All cases were openly
reduced and internally fixed with 3.5 mm LCDCP. Fracture was common in second and third decade
with average age of 43 years (18-64 years). In our study, male preponderance was found with 74% males
and 26% female patients. Side affected 32 (64%) Left side and 18 patients (36%) right side. Mode of
injury in the present study, RTA (60%), fall (30%) and assault (10%). An average time for union was 17
weeks Results were evaluated by Andersons scoring system. In present study, we had 45 patients (90%)
with excellent results, 4 case (8%) as satisfactory and 1 case (2%) as failure which required refixation. In
the present study there was 3 case (6%) of superficial infection, 1 case (2%) of non-union of radius which
required refixation with bone grafting.
Conclusion: LC-DCP can be considered the best mode of treatment for closed diaphyseal fractures of
both bones forearm.
Keywords: Both bones forearm, diaphyseal fractures, limited contact dynamic compression plate,
Andersons scoring system
Introduction
The forearm has a complex architecture consisting of two mobile relatively parallel bones that
provide a stable link between the elbow and the wrist and serve as the origin of several
muscles inserting on the hand. As a result, fracture of both bones forearm present unique
problems not encountered with fractures of the shafts of other long bones. Restoration of
forearm rotation, elbow and wrist motion and grip strength has been shown to be facilitated by
anatomic reduction and internal fixation of these fractures
[1]
.
The forearm rotation is the most important contribution to the rotational mobility of upper
limb. The two-bone unit with its proximal and distal radio-ulnar joints, and its rotational axis
connecting the centres of the two, have been viewed as a single bicondylar joint. When
combined with rotational motion of the shoulder, forearm rotation permits the hand to be
positioned through an entire 360o arc of motion. With the shoulder fully abducted, nearly all
of the rotational motion of the upper limb occurs through the forearm. Activities such as,
accepting objects in the palm of the hand require nearly full forearm supination while many
other functional tasks require some degree of pronation
[2]
.