A CLINICAL STUDY ON INTERNAL FIXATION OF DIAPHYSEAL FRACTURES OF BOTH BONES FOREARM WITH DYNAMIC COMPRESSION PLATE
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 11
Abstract
BACKGROUND With mechanized farming in India and industrialization, both bone forearm fractures have become common. If the fractures are treated inadequately, it may result in severe loss of function. So, in order to restore function, anatomical reduction and internal fixation is necessary. Union may be achieved with any of the methods available; however, severe loss of function may be the end result unless adequately treated with proper technique and implants. With the development of compression plate osteosynthesis which provides a good treatment option and predictable outcome, there is an important change in the treatment of forearm fractures. This method helps in perfect reduction of fracture fragments in anatomical position by rigid fixation and early mobilization, the normal functions of the hand can be achieved at the earliest. MATERIALS AND METHODS In this study, 30 patients with forearm fractures, were treated by open reduction and internal fixation with 3.5 mm dynamic compression plate (DCP) and screws in patients with displaced fractures of the shaft of forearm bones. This study was conducted from February 2017 to January 2019 at Government General Hospital, Kurnool (attached to Kurnool Medical College, Kurnool). RESULTS On an average, follow up period of these patients was 12 months. The results were correlated under Anderson et al, scoring system. There were 23 (76.66%) patients with excellent results, 5 (16.66%) patients with satisfactory results and 1 (3.33%) patient with unsatisfactory result and 1 (3.33%) patient had failure. Unsatisfactory result was due to comminution of fracture (prolonged immobilisation) and patient non-cooperation for instructions. CONCLUSION Post operatively, with DCP fixation, additional supportive measures may not be required after soft tissue healing and shoulder elbow and wrist movements can be started early. This helps prevent muscle atrophy and joint stiffness. It is very much possible in intelligent and cooperative patients. However, all patients should be curtailed from lifting heavy weights till union of fracture. Almost all fractures in our study united by 4-6 months. The AO principles of internal fixation namely (1) anatomical fixation, (2) preservation of vascularity, (3) mechanically stable fixation, (4) rapid mobilization of joints in proximity, can be achieved with compression plating system. With rigid/anatomical internal fixation, dynamic compression plate is a good fixation for displaced diaphyseal fractures of the forearm bones. Adherence to AO principles, strict asepsis, proper post-operative rehabilitation and patient education are more important to obtain excellent results. Also, external immobilization was not necessary in intelligent and co-operative patients. Therefore, internal fixation with dynamic compression plate appears to be the gold standard for fractures of forearm.
Authors and Affiliations
Aasupathri Pavana Kumar Babu, Rajesh Kumar Mallepogu, Sreekanth Reddy B. , Thadi Raghavendera Rao
Keywords
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- EP ID EP615535
- DOI 10.18410/jebmh/2019/177
- Views 90
- Downloads 0
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