Journal of Musculoskeletal Trauma

Operative Treatment of Pediatric Distal Forearm Bothbone Fracture: Sang Uk Lee, Changhoon Jeong, Il Jung Park, Jaeyoung Lee, Seman Oh, Kyung Hoon Lee, Sanghyun Jeon; J Korean Fract Soc 2015;28(4):237-244. Published online October 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.4.237

Abstract PDF: PURPOSE
Pediatric patients with distal forearm bothbone fractures of surgical indication were treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna at our institution. The purpose of this study is to evaluate clinical and radiological results.
MATERIALS AND METHODS
From February 2012 to June 2014, we retrospectively evaluated 16 out of 18 cases with distal forearm bothbone fractures treated with the Kapandji reduction technique for radius and flexible intramedullary nail for ulna with at least 1-year follow-up. The average age at operation was 9.1 years (7-13 years).
RESULTS
Adequate reduction for both radius and ulna was achieved for all cases, and none of the cases showed re-displacement until the last follow-up. Mean 6.6 weeks lapsed until bony union was observed for the radius. For the ulna, the mean was 6.5 weeks. All patients gained full wrist range of motion at the last visit.
CONCLUSION
For pediatric distal forearm bothbone fractures, intrafocal Kapandji reduction and internal fixation with Kirschner wire for radius and reduction and internal fixation with a flexible intramedullary nail for ulna is the technique for handy reduction. Use of this technique can prevent re-displacement during the union process and achieve excellent clinical and radiologic results.

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Interlocking Intramedullary Nailing of Forearm Shaft Fractures in Adults: Sanglim Lee, Hee Sung Lee, Yerl Bo Sung, Jae Kwang Yum; J Korean Fract Soc 2009;22(1):30-38. Published online January 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.1.30

PURPOSE
To evaluate the usefulness of interlocking intramedullary nailing for operative treatment of forearm shaft fractures in adults.
MATERIALS AND METHODS
Thirteen forearm shaft fractures in 12 patients were fixated with 13 Acumed forearm intramedullary rods (ulna: 8, radius: 5). The average age was 36.7 years and mean follow-up period was 15.2 months. The union time was measured when there was no tenderness over the fracture site and the bridging callus was evident in at least two sides of the cortex. The range of motion of the joint and the rotation of the forearm was measured and the functional results were evaluated with Grace and Eversmann's rating system.
RESULTS
Radiologic union was observed at 11.8 weeks postoperatively in 11 cases out of 13. No limitation of motion was observed. Nine had excellent or good functional results. In one Galeazzi fracture, radial shaft became displaced after nailing and should be re-stabilized with plate. Proximal interlocking screws were improperly inserted in one ulnar nail. Implants were removed in 7 cases. Removal guide screw was broken while removing the intramedullary nail in one case of ulnar shaft fracture.
CONCLUSION
Interlocking intramedullay nailing might be a treatment option for the middle 1/3 shaft fractures of the adult forearm bone with favorable results.

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Comparison of minimally invasive plate osteosynthesis (MIPO) and open reduction and internal fixation (ORIF) for the treatment of radial shaft fractures: a retrospective study
Hyun-Tak Kang, Yang-Hoon Jo, Hong-Je Kang
BMC Musculoskeletal Disorders.2025;[Epub] CrossRef
Distal blocking screw augmentation in ulnar intramedullary nail fixation of adult forearm diaphyseal fractures
Yong Woo Kim, Sang Ki Lee, Young Sun An
Journal of Orthopaedic Surgery.2024;[Epub] CrossRef
Comparison of Bending Strength among Plate, Steinmann Pin, and Headless Compression Screw Fixations for Proximal Ulnar Shaft Fracture in Sawbones
Jinyoung Han, Jin Rok Oh, Jaewoong Um
Archives of Hand and Microsurgery.2020; 25(4): 267. CrossRef

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Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail: Kwang Yul Kim, Moon Sup Lim, Shin Kwon Choi, Hyeong Jo Yoon; J Korean Fract Soc 2008;21(2):157-164. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.157

Abstract PDF

PURPOSE
To evaluate the result of forearm shaft fracture treated by modified interlocking intramedullary nail (Acumed, Hillsbrough, IN, USA).
MATERIALS AND METHODS
15 patients with fracture of radius, ulna, radio-ulna shaft treated by modified interlocking intramedullary nail from December 2003 to February 2007 were analyzed. Modified interlocking intramedullary nail has paddle blade tip and fluted rod, so the distal screw fixation was not needed but had relatively firm fixation. It has advantages including short operation time, small operation scar. The average follow up period was 8.3 months (range, 5~15 months). We analyzed the results by average union time and the functional results according to Anderson's criteria.
RESULTS
The mean duration of union was 9.8 weeks in radius and 11.4 weeks in ulna. The average range of motion of forearm was 74.6 degree in supination and 72 degree in pronation.. Functional results assessed by Anderson were rated excellet in 12 cases, satisfactory in 3 cases. We found no complications such as delayed union, non-union, neurovascular injury and infection.
CONCLUSION
Modified interlocking intramedullary nail (Acumed, Hillsbrough, IN, USA) is a viable therapeutic alternative in the management of forearm shaft fracture.

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Interlocking Intramedullary Nailing of Forearm Shaft Fractures in Adults
Sanglim Lee, Hee-Sung Lee, Yerl-Bo Sung, Jae-Kwang Yum
Journal of the Korean Fracture Society.2009; 22(1): 30. CrossRef

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Pediatric Forearm Bone Fractures Treated with Flexible Intramedullary Nail: Suk Kyu Choo, Jin Hwan Kim, Hyung Keun Oh, Dong Hyun Kim; J Korean Fract Soc 2007;20(2):190-195. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.190

Abstract PDF: PURPOSE
To determine the usefulness of flexible intramedullary fixation in pediatric forearm diaphyseal fractures.
MATERIALS AND METHODS
We reviewed 22 cases of forearm diaphyseal fractures treated with flexible intramedullary nail and K-wire. The radiographic assessment was based on the time to union, maintenance of reduction and angular deformity. The functional outcome was assessed with the range of motion and complications at last follow up.
RESULTS
Average length of follow up was 13.9 months with mean age of 10.8 years and the time to union was 5.2 weeks. There were no angular deformity and fuctional results were excellent in all cases. There were 5 cases of soft tissue irritation of nail insertion site as post operative complication which was resolved after nail removal.
CONCLUSION
Flexible intramedullary for pediatric forearm bone fractures is an effective and safe method which gives a good functional outcome.

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Percutaneous Transphyseal Intramedullary K-wire Fixation for the Diaphyseal Forearm Fractures in Children: Jung Hoei Ku, Young Chul Go, Man Jun Park; J Korean Fract Soc 2006;19(3):374-377. Published online July 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.3.374

Abstract: PURPOSE
Although the standard treatment of diaphyseal forearm fractures in children is conservative treatment with closed reduction and cast immobilization, unstable or irreducible fractures are usually needed by surgical intervention. The aim of this article is to determine the efficacy of the percutaneous transphyseal intramedullary K-wires fixation for the forearm diaphyseal fractures in children.
MATERIALS AND METHODS
In this retrospective study, we reviewed 18 cases of forearm diaphyseal fractures in children, which were treated with percutaneous transphyseal intramedullary nailing using K-wires from January 2001 to December 2004. We analyzed the period for radiologic bone union and the complications until the last follow-up.
RESULTS
The average period of follow-up was 15 months with mean age of 7.8 years. The average time to bone union was 6.2 weeks and nonunion, malunion, radio-ulnar synostosis and refracture were not found, just 2 local pin site infections were seen but healed by conservative treatment. Postoperative scar was small and the complications until the last follow-up were not found.
CONCLUSION
In the operative treatment of the forearm diaphyseal fractures in children, we think percutaneous transphyseal intramedullary K-wire fixation is one of the effective methods because of the minimal invasiveness, simplicity and easiness in removal.

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Flexible Intramedullary Pin Fixation of Both Forearm Bone Fractures in Children: Young Jin Sohn, Yong Woon Shin, Hyung Jin Chung, Sang lim Lee, Jae Kwang Yum, Yerl Bo Sung, Jong Kuk An, Eul O Choi; J Korean Fract Soc 2006;19(2):271-276. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.271

Abstract: PURPOSE
To evaluate the efficacy of Flexible intramedullary pin fixation in pediatric forearm diaphyseal fractures.
MATERIALS AND METHODS
In this retrospective study, we reviewed 15 cases of forearm diaphyseal fractures operated using flexible intra-medullary nail fixation technique between January 2000 and December 2004. Of these 15 children, there were 11 boys and 4 girls with an average age of 11.6 years (range, 7~15 years). The implants were introduced in the distal radius and proximal ulna in all patients. An average duration of fixation was 5.3 months in the radius, 4.7 months in the ulna. After operation, all patient were applied with a long arm cast and the duration of immobilization was 5.2 weeks (range, 4~6 weeks) on average.
RESULTS
All fractures in this series healed with normal range of supination (average 80.0) and pronation (average, 71.6 degrees). Average operation time including anesthesia was 123 minutes and hospital stay was 5.4 days. Time to union was 8.4 weeks on average. Range of motion and functional results were satisfactory in all cases. There were one case of incomplete ulnar nerve injury and two cases of refracture which were treated conservatively without any permanent complication.
CONCLUSION
Flexible intramedullary pin fixation technique is a good method in case of unstable displaced fracture and difficult or failed closed treatment.

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Treatment of Diaphyseal Fractures of Forearm Both Bones: Comparison between Plate Fixation and Rush Pin Intramedullary Nailing: Myung Ho Kim, Moon Jib Yoo, Hong Geun Jung, Hee Gon Park, Woo Sup Byun, Ji Yong Chun, Suk Ha Jeon; J Korean Fract Soc 2006;19(2):215-220. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.215

Abstract

PURPOSE
To compare the functional results between the plate fixation and Rush pin insertion for the treatment of diaphyseal fractures of the forearm both bones.
MATERIALS AND METHODS
We reviewed 51 patients who were treated for diaphyseal fractures of the both forearm bones from 1995 to 2003, and evaluated them with Anderson's method. Eighteen patients were treated with plate fixation of both bones (group I), 14 patients treated with of the Rush pin insertion of the radius and plate fixation of the ulna (group II), 11 patients treated with plate fixation of the radius and Rush pin insertion of the ulna (group III), and 8 patients treated with Rush pin insertion of forearm both bones (group IV).
RESULTS
Seventeen out of eighteen cases obtained favorable result (94.4%) in group I, 12 out of 14 cases (85.7%) in group II, 7 out of 11 cases (63.3%) in group III, and 4 out of 8 cases (50.0%) in group IV with statistically significant differences between the groups (p=0.04).
CONCLUSION
Plate fixation of forearm both bones yield the best result. Thus, plate fixation of both forearm bones is recommended in treating the diaphyseal fractures of both forearm bones. At least one bone is recommended to be fixed with a plate if it is not possible to fix both forearm bones with plates.

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Shaft Fractures of Both Forearm Bones: The Outcomes of Surgical Treatment with Plating Only and Combined Plating and Intramedullary Nailing
Sang Bum Kim, Youn Moo Heo, Jin Woong Yi, Jung Bum Lee, Byoung Gu Lim
Clinics in Orthopedic Surgery.2015; 7(3): 282. CrossRef
Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail
Kwang-Yul Kim, Moon-Sup Lim, Shin-Kwon Choi, Hyeong-Jo Yoon
Journal of the Korean Fracture Society.2008; 21(2): 157. CrossRef

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Multiple Fractures of Forearm Both Bones: A Case Report of 5 Separate Sites: Bu Hwan Kim, Moo Ho Song, Seong Jun Ahn, Seong Ho Yoo, Min Soo Lee; J Korean Fract Soc 2005;18(4):466-469. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.466

Abstract PDF

We have experienced multiple fractures of forearm both bones, which revealed the following fractures: comminuted fracture of olecranon, short oblique fracture of proximal ulnar shaft, transverse fracture of ulna mid-shaft, comminuted fracture of radial head, comminuted fracture of distal radius.

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Treatment of a Segmental Ulnar Shaft Fracture and an Olecranon Fracture
Myoung Soo Kim, Kyu Pill Moon, Hyung Joon Cho, Jung Yun Bae, Kuen Tak Suh
Journal of the Korean Orthopaedic Association.2010; 45(6): 496. CrossRef

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Reduction of Pediatric Forearm Diaphyseal Fractures by Pin Leverage Technique: Soo Hong Han, Duck Yun Cho, Hyung Ku Yoon, Byung Soon Kim, Sung Hoon Kang, Tae Hyung Kim; J Korean Fract Soc 2004;17(1):59-63. Published online January 31, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.1.59

Abstract PDF

PURPOSE
Although the majority of children's forearm diaphyseal fractures may be treated conservatively with closed reduction and cast immobilization, unstable or irreducible fractures are usually treated by surgical management. Authors performed percutaneous pin leverage reduction technique for irreducible displaced diaphyseal fractures. The aim of this study is to determine the efficacy of pin leverage technique in pediatric forearm diaphyseal fractures MATERIALS AND METHODS: In this retrospective study, we reviewed 22 cases of forearm diaphyseal fractures reduced by percutaneous pin leverage technique between 1997 and 2002. We analyzed radiographs, operation time, hospital stay and immobilization period, range of motion, postoperative complications and functional results by Thomas.
RESULTS
Average length of follow up was 28 months with mean age of 10.5 years. All fractures in this series healed less than 2 degrees of diaphyseal angulation. Average operation time including anesthesia was 42 minutes and hospital stay was 4.6 days. Time to union was 49.6 days in average and range of motion and functional results were satisfactory in all cases except one case of congenital radioulnar synostosis. There was one case of superficial pin track infection as complication.
CONCLUSION
In operative treatment of children's diaphyseal fractures of forearm bones, percutaneous pin leverage reduction technique is a good alternative method prior to open reduction in case of difficult closed reduction.

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Pediatric Forearm Bone Fractures Treated with Flexible Intramedullary Nail
Suk Kyu Choo, Jin Hwan Kim, Hyung Keun Oh, Dong Hyun Kim
Journal of the Korean Fracture Society.2007; 20(2): 190. CrossRef

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Functional Evaluation of Wrist According to Changes of Length after Operation in Fracture of Both Bones of Forearm: Seung Suk Seo, Ki Yong Kim, Jang Seok Choi, Young Chang Kim, Jae Keun Park; J Korean Soc Fract 2003;16(1):74-82. Published online January 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.1.74

Abstract PDF: PURPOSE
To evaluate the relationship between the length changes of both forearm bones and function of wrist. To know permitted length discrepancy for good wrist function after operation in fracture of both bones of forearm MATERIALS AND METHODS: From Jan. 1995 to Dec. 2000, 21 cases were followed over 1 year, were treated with compression plate and screws due to fracture of both bones of forearm in our hospital. Mean duration of follow-up was 3 years 6 months. The postoperative length difference was compared to preoperative or unaffected side in roentgenography. Four groups were defined to A, B, C and D by postoperative length difference ; < or =1mm, 1 2mm, 2 3mm, and >3mm for comparison. The function of wrist joint was evaluated with the Anderson 's classification and Mayo modified wrist score.
RESULT
Group A were 11 cases(52.3%), B 5 cases(23.8%), C 4 cases(19.0%) and D 1 case(4.8%). By the Anderson 's classification, the number of Excellent were 11 cases(52.3%), Good 7(33.3%), Fair 3(14.3%). In the group of the length difference lesser than 2mm, the number of Excellent were 11, and Good 5. The Mayo modified wrist score was 75.15 in the group of the length difference lesser than 2mm, that was higher than 61.15 in the group of more than 2mm.
CONCLUSION
To obtain a good wrist function after operative treatment of fracture of both bones of forearm the length discrepancy of both bones should be lesser than 2mm.

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Operative treatment of diaphyseal fractures of both forearm bones in adults: Eui Hwan Ahn, Sung Tae Lee, Ja Heon Koo; J Korean Soc Fract 2001;14(2):245-252. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.245

Abstract PDF

PURPOSE
The purpose of this study is to evaluate the effectiveness of operative methods for diaphyseal fractures of both forearm bones in adults.
MATERIALS AND METHODS
Forty five cases with diaphyseal fractures of both forearm bones over 18 year old that are treated by operative methods from January 1994 to December 1998 were followed and analyzed. The most common age group was 3rd and 4th decade(each, 24.4%). Traffic accident was the most common cause of injuries(31.2%). Among both the radius and ulna, middle 1/3 was the most common level of fractures(60%, 57.8%). In operative methods, open redeuction and internal fixation with dynamic compression plate(D.C.P.) and screws were performed in 39 cases, closed reduction and internal fixation with Rush pin were performed in 5 cases, And another 1 case was performed with D.C.P. and Rush pin simultaneously.
RESULTS
According to simple X-ray and physical examinations, The average of bone union periods was 12.7 weeks in radius, 13.5 weeks in ulna. The range of bone union periods according to the level of fractures was from 12.4 weeks to 14.1 weeks. For the functional results assessed by Grace and Eversmann method, excellent was 48.9%, good was 35.6%, acceptable was 11.1% and unacceptable was 4.4%.
CONCLUSION
The functional result was satisfactory in 84.5%. So the operative method of diaphyseal fractures of both forearm bones, if proper operative method had been selected and meticulous surgical technique had been performed, was considered as recommendable method.

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Treatment of a Segmental Ulnar Shaft Fracture and an Olecranon Fracture
Myoung Soo Kim, Kyu Pill Moon, Hyung Joon Cho, Jung Yun Bae, Kuen Tak Suh
Journal of the Korean Orthopaedic Association.2010; 45(6): 496. CrossRef

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Treatment of Diaphyseal Fractures of the Forearm Both Bones: Jae Ik Shim, Taik Seon Kim, Sung Jong Lee, Suk Ha Lee, Young Bae Kim, Jeong Ro Yoon, Jeong Su Yoo; J Korean Soc Fract 2000;13(4):1016-1023. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.1016

Abstract PDF

PURPOSE
To analyze the clinical and radiological result of diaphyseal fractures of the forearm both bones treated by plate fixation and plate fixation with intramedullary nailing.
MATERIALS AND METHODS
We reviewed 52 cases of diaphyseal fractures of the forearm both bones in adults that were treated and the follow-up period was 1 year above. The first group(I), 25 cases(48.1%) were treated with plate fixation in radius and ulna, the second group(II), 27 cases(51.9%) were treated with plate fixation in radius and threaded Steinman pin fixation in ulna. we analyzed the results by average union time and functional result according to Anderson's criteria.
RESULTS
The mean duration of union was in the first group, 12.3 weeks in the second group, 13.2 weeks. By Anderson's criteria, in the first group, 21 cases(84%) and in the second group, 22 cases(81.5%) had a good result. As complications in the first group, non-union 2 case, angulation deformity 1 case, rotational deformity 1 case and in the second group, non-union 4 cases, angulation deformity 2 cases.
CONCLUSION
We considered that satisfactory results can be obtained by rigid internal fixation with plates in radius & ulna and early mobilization in fractures of forearm both bones in adults and according to the type of fracture, Fixation with plate in radius and threaded Steinman pin in ulna was one of the proper methods.

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Treatment of a Segmental Ulnar Shaft Fracture and an Olecranon Fracture
Myoung Soo Kim, Kyu Pill Moon, Hyung Joon Cho, Jung Yun Bae, Kuen Tak Suh
Journal of the Korean Orthopaedic Association.2010; 45(6): 496. CrossRef
Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail
Kwang-Yul Kim, Moon-Sup Lim, Shin-Kwon Choi, Hyeong-Jo Yoon
Journal of the Korean Fracture Society.2008; 21(2): 157. CrossRef

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Comparison of the Clinical Results Between the Plate Fixation and Intramedullary Nailing for the Diaphyseal Both Forearm Bone Fractures: Hyun Dai Shin, Kwang Jin Rhee, Jun Young Yang, Sung Ho Yun, Mun Jong Lee; J Korean Soc Fract 1999;12(1):135-144. Published online January 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.1.135

Abstract PDF

The fractures of the forearm bone are common and the forearm has the specific movement of supination and pronation. So, the goal of the treatment of forearm fractures is the recovery of rotatory function of the forearm as well as the function of the elbow and wrist. Surgical treatment usually is not necessory in children under 10 years of age because of remodelling potential and spontaneous correction ability. But, anatomical reduction and rigid fixation is essential in fractures of adult forearm above 15 years of age because of rotational deformity and angulation after forearm fractures may result in serious functional problems of the forearm. The purpose of the our retrospective study is to compare the clinical result between the plate fixation and intramedullary nailing of the diaphyseal both forearm bone fractures in adult. We reviewed 64 patients above 15 ages who had diaphyseal both forearm bone fractures, and were treated with fixation using compression plate or Rush pin. Forty patients were treated with both plates, 7 patients with both Rush pins, and 17 patients with plate and rush pin. Galeazzi or Monteggia fractures were excluded in this study. On final follow up, we performed the radiological analysis and compared the operation interval, immobilization period after operation, bone union time, functional result and complications in these groups. Functional results was more higher in both plate fixation, and complications were high in both intramedullary nailing. In conclusion, both plate fixation is the best treatment method in the diaphyseal both forearm bone fractures in adult. Thus in both forearm bone fractures, both plate fixation is recommended, but if it is not available, at least one bone with plate fixation is necessary

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Interlocking Intramedullary Nailing of Forearm Shaft Fractures in Adults
Sanglim Lee, Hee-Sung Lee, Yerl-Bo Sung, Jae-Kwang Yum
Journal of the Korean Fracture Society.2009; 22(1): 30. CrossRef
Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail
Kwang-Yul Kim, Moon-Sup Lim, Shin-Kwon Choi, Hyeong-Jo Yoon
Journal of the Korean Fracture Society.2008; 21(2): 157. CrossRef

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The Operative Treatment of the shaft Fractures of the Forearm Bone: Operative Comparison in Intramedullary Fixation to Plate Fixation on Treatment of the Both Forearm Bone Fracture: Chung Nam Kang, Jong Ho Kim, Dong Wook Kim, Young Do Gho, Jae Doo You, Jong Keon Oh, Jin Chang; J Korean Soc Fract 1998;11(1):63-69. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.63

Abstract PDF

Diaphyseal fractures of the radius and ulna present high incidence of malunion and nonunion because of difficulty in reduction and maintenence of two mobile, parallel ones in the presence of the pronating and supinating muscles which exert angulatory as well as well as rotational forces. The author divided the traceable patients into two groups, the one was the group treated with AO compression plates and the other one was the roup treated with Rush pin in radius and AO compression plate in ulna, and compared the results in the aspect of healing time and functional results. The results were as follows; 1.Those two groups were demographically similar. 2.The immobilization period and the radiologic bone union time did not differentiate two groups significantly. 3.In plate group, one nonunion, one nerve injury and two superficial wound infection were occurred. 4.Between the two operative methods selected alternatively, immobilization period, radiologic bone union and fuctional results were not different significantly, but the Rush pinning method was preferred due to simple operation technique, small operation scar, short operation time, a little blood loss, a few complication.

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Shaft Fractures of Both Forearm Bones: The Outcomes of Surgical Treatment with Plating Only and Combined Plating and Intramedullary Nailing
Sang Bum Kim, Youn Moo Heo, Jin Woong Yi, Jung Bum Lee, Byoung Gu Lim
Clinics in Orthopedic Surgery.2015; 7(3): 282. CrossRef
Interlocking Intramedullary Nailing of Forearm Shaft Fractures in Adults
Sanglim Lee, Hee-Sung Lee, Yerl-Bo Sung, Jae-Kwang Yum
Journal of the Korean Fracture Society.2009; 22(1): 30. CrossRef

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Analysis of the Operative Treatment of Ipsilateral diaphyseal Fractures of the Humerus and Forearm: Jung Ryul Kim, Kyung Jin Song, Sung Jin Kim, Jun Mo Lee, Byung Yun Hwang; J Korean Soc Fract 1998;11(1):34-40. Published online January 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.1.34

Abstract PDF

Twenty-six adults who had concomitant ipsilateral shaft fracture of the humerus and forearm were managed with operative treatment. The mean age was 41 years (range 20 to 55 years), and the mean follow-up was 3.3 years (range 1.5 to 6 years). We reviewed initial soft tissue injury, presence of open fracture, and evaluted radiologic bone union. The functional outcome assessed with rating system of Lange and Foster, which is based on terms of fracture healing and functional restoration of the upper extremity. Overall rate of union for the humerus was 88.4 per cent, for the radius was 82.6 per cent and for the ulna 84.2 percent. We found no difference in average time to union between the treatment group with regard to open reduction and plate fixation or intramedullary nailing in the humerus and forearm bones (P>0.1, Wilcoxon signed rank test). But radiologic evaluation revealed a significant correlation between presence of open fracture and average time to union. The functional result was good in 12 cases (46%), fair in 6 cases(23%), and poor in 8 cases (31 %) according to Lange and Foster criteria. There were four nonunions of the humerus, three of the radius, and three of the ulna. Infection occurred three patients. Other complications were high radial nerve palsy in one case and above elbow amputation in one case. The results following injury were affected both by the severity of the initial trauma and by the treatment given. Best chance for a functional outcome will result from stable fixation of both the humeral and the forearm components.

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Classic Floating Elbow in Adults: A Case Series
Chul-Hyun Cho, Kyung-Keun Min
Clinics in Shoulder and Elbow.2015; 18(1): 8. CrossRef

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Remodelling and Reangulation following the Fracture of Both Bones of the Forearm in Children: Sung Tae Lee, Jeong Hwan Oh, Eui Hwan Ahn, Hyuck Jun Lee; J Korean Soc Fract 1997;10(4):972-978. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.972

Abstract PDF: One-hundred fifty children underwent closed reduction for the fracture of both bones of the forearm were retrospectively reexamed with an average follow-up time of 28.7 months(range, 13-60 months). Patients were divided into three groups of 50-complete fractures, 50-green-stick fractures broken intact cortex and 50-green-stick fractures preserved intact cortex. The rate of the reangulation after closed reduction was lowest on the green-stick fractures preserved intact cortex. Forty-seven patients with residual angulation after healing were divided into two age groups of 4-10 years and 10- 15 years at the time of fracture. In children younger than 10 years of age with residual angulation after distal fractures of both bones of the forearm, the change of orientation of the epiphyseal plate toward the normal seemed to account for nearly all the actual correction at the site of fracture. The hinge should be used to aid in an accurate and stable reduction. The importance of the orientation of the epiphyseal plate is related to the distance between the fracture site and the epiphyseal plate according to the age of the patient.

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Functional Outcome after Operative Treatment of the Fractures of the Forearm Both Bones: Jung Ryul Kim, Kyung Jin Song, Joo Won Jung, Jun Mo Lee, Byung Yun Hwang; J Korean Soc Fract 1997;10(4):934-939. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.934

Abstract PDF

Twenty-seven adults who had a closed fracture of both bones of the forearm were managed with plate in twenty-four radial and twenty-three ulnar fracture. and with intramedullary nailing in three radial and four ulnar fractures. And were followed for a mean three years and two months(range, one year to six years). Standard anterioposterior and lateral radiographs were made of both forearms, and evaluated bone union that was qualified by measurement of the amount and location of the maximum radial bow in the relation to the contralateral normal ram. The functional outcome was assessed with rating system of Anderson, which is based on union of the fracture and rotation to the forearm, also with measurement of grip strength. Overall rate of union for the radius was 92.5 per cent and for the ulna 96.2 per cent. Average time to union was 10.4 weeks in the radius and 10.3 weeks in the ulna. Twenty-three patients(84%) had an excellent, good, or acceptible functional results, according to the criteria of Anderson. At follow-up, the mean and standard error for motion of the elbow from 64.0+/-4.1 of pronation to 74.3+/-4.2 supination. Seventeen patients(63%) had a grip strength that was more than 80 per cent of that of the contralateral side. Mean maximal radial bow was 15.1+/-0.4 millimeter and mean location of radial bow was 61.2+/-1.1 per cent in the normal arm. There was good or excellent rotation of the forearm, the rotation was close to where it was in the normal extremity. When five radial and three ulnar transverse fractures which were treated with less than five-hole plate, radiographic union was delayed(mean 13.3 weeks) and less satisfactory restoration of the function were obtained. However eleven radial and nine ulnar transverse fractures which were treated with more than six-hole plate were all united(mean 10.2 weeks) and acceptible restoration of the function were obtained Overall, there were three nonunions(two radial and one ulnar fracture), and one infection. Restoration of the normal radial bow was related to functional outcome. A good functional result was associated with restoration of the normal amount and location of the radial bow. Plating with more than six cortex secured by screws on each side of the fracture, provided a successful method for obtaining union and optimum function after fractures of the foream.

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Treatment of Forearm Shaft Fracture with Modified Interlocking Intramedullary Nail
Kwang-Yul Kim, Moon-Sup Lim, Shin-Kwon Choi, Hyeong-Jo Yoon
Journal of the Korean Fracture Society.2008; 21(2): 157. CrossRef

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Operative Treatment of Forearm Fractures in Children: Nam Gee Lee, Seung Ki Kim, Won Jong Bahk, Hyun Joon Song, Ban Chang; J Korean Soc Fract 1997;10(1):195-202. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.195

Abstract PDF: Management of severe diaphyseal fracture of radius and ulna in children can be a challenging problem. Reduction and maintenance of the position of two mobile parallel bones is difficult because pronating and supinating muscles produce angulatory as well as rotational forces. Open reduction and internal fixation are generally accepted for adult forearm fractures, but controversy surrounds open reduction for children. What should be done for the irreducible fracture that will result in a malunion? Several authors advocate open reduction in children over 10 years of age rather than accept poor position. And others advocate open reduction regardless of age if closed reduction is unsatisfactory. We reviewed thirteen children between 6-14 years of age, who had irreducible fractures of diaphysis of forearm both bone, and who were treated with open reduction and internal fixation with plate for mid 1/3 fractures(4 cases) and open reduction and internal fixation with K-wires for distal 1/3 fractures(9 cases). The results were as follows; 1. 2 cases(15%) had limitation of pronation within 10 comparing with uninjured side. But 11 cases(85%) had equal movements on both sides. And the range of motions of the elbow and wrist are within normal limit. 2. More than 20 angulation for mid 1/3 fracture over 10 years of age, and more than 20 angulation or 20% displacement for distal 1/3 fracture over 6 years of age, it would be better to perform a surgical treatment if nonsurgical treatment was failed. 3. Immobilization periods were 5 weeks for plate fixation group and 6.9 weeks for K-wire fixatioin group. Bone union was occurred in all cases, at 9 weeks in plate fixation group and 8 weeks in K-wire fixation group. 4. Its better to fix with plate ofr promimal 2/3 fracture and K-wire for distal 1/3 fracture in case of operation. In conclusion, our results of open reduction and internal fixation were satisfactory if adequate alignment of fractures had not been achieved or maintained.

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Clinical Comparison in Intramedullary Fixation to Plate Fixation on Treatment of the Both Forearm Bone Fractures: Seog Yeong Jeong, Ung Moon, Soo Jae Yim, Seung Ryeol Yoon, Soo Kyun Rah, Chang Uk Choi; J Korean Soc Fract 1995;8(4):893-901. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.893

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The diaphyseal fractures of radius and ulnar have many problems like nonunion, malunion and functional disturbance with conservative treatment. Therefore, open anatomical reduction and rigid internal fixation have been widely used. The plate fixation has been employed in most both forearm bone fractures and the intramedullary pinning usually used in cases of the open fractures, comminuted types, multiple fractures or poor general conditions. Seventeen patients were treated with semitubular plate and eighteen cases by the closed or open reduction and intramedullary fixation with Rush pin(the operation methods were decised alternatively) were followed up more than one year at Soonchunhyang Gumi Hospital from June 1988 to Nov. 1992 and the results were compared and analyzed clinically. 1. Those two groups were demographically similar. 2. The operation time was 65 minites in Rush pin group, 85.6 minutes in plate group and the blood loss was 37.1cc in Rush pin group,85.3cc in plate group. 3. The immobilization period and the radiologic bone union time did not differentiate two groups significantly. 4. In plated group, one nonunion and one radius refracture after union(plate removed state) were occurred. 5. Between the two operatio methods selected alternatively, immobilization period, radiologic bone union and functional results were not different significantly, but the Rush pinning method was preferred due to simple operation technique, small operation scars, short operation time, a little blood ioss, a few complications.

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Comparison of Locking versus Dynamic Compression Plates for Treatment of Diaphyseal Forearm Fracture
Yong Chan Lee, Hong Je Kang
Journal of the Korean Society for Surgery of the Hand.2015; 20(4): 168. CrossRef
Pediatric Forearm Bone Fractures Treated with Flexible Intramedullary Nail
Suk Kyu Choo, Jin Hwan Kim, Hyung Keun Oh, Dong Hyun Kim
Journal of the Korean Fracture Society.2007; 20(2): 190. CrossRef

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The Operative Treatment of the Shaft Fractures of the Forearm Bone: Sang Won Park, Geol Choi; J Korean Soc Fract 1995;8(1):199-205. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.199

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The reduction and maintenance of the disphyseal fractures of the forearm bone are difficult due to the special rotational movement between two bones. Over the years various methods of operative treatment have been advocated, and good method must be selected as the fracture level, the fracture type, and the patients general condition. From May 1988 to August 1993, the authors have reviewed 50 patients of the forearm shaft fracture except the solitary radius or ulna fracture with minimum 1 year follow up which were treated in Department of Orthopedic Surgery, Korea University Hospital. The results obtained were as follows, 1. The most common cause of injury was the traffic accident(38%) and the next was the fall down(24%). The most frequent level of the fracture was middle one-third(54%) and the most common type of the fracture was transverse fracture(64%). The treatment methods were 32 cases of the compression plate and screw fuation in the radius and ulna, and 18 cases of the compression plate and screw fixation in radius and the intramedullary nailing in ulna. 2. The average duration of the radiological union of compression plate and screw fixation of radius and ulna was 12.5 weeks in radius and 12.1 weeks in ulna, and 12.8 weeks of radius and 15.2 weeks of ulna in cases of compression plate and screw fixation of radius and intramedullary nailing of ulna. 3. According to Grace and Eversmanns evaluation, satisfactory results (Excellent and Good) were 81.5% of compression plate and screw fixation and 83.3.To of compression plate and screw fixation of radius and intramedullary nailing of ulna. 4. Postoperative complication were 2 cases of superFicial wound infection and each 1 case of transient posterior interosseous nerve injury, non-union and non-union with metal failure in compression plate and screw fixation of both radius and ulna, and 1 case of non-union in intramedullary nailing of the ulna.

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Comparison of Locking versus Dynamic Compression Plates for Treatment of Diaphyseal Forearm Fracture
Yong Chan Lee, Hong Je Kang
Journal of the Korean Society for Surgery of the Hand.2015; 20(4): 168. CrossRef

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Surgical Treatment of Concomitant Ipsilateral Humerus and Forearm Fractures: Jeung Tak Suh, Sung Hun Kim, Chong Il Yoo; J Korean Soc Fract 1994;7(2):316-321. Published online November 30, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.2.316

Abstract PDF: The term "floating elbow" refers to concomitant ipsilateral humeral and forearm bone fractures. This type of fractures is relatively rare and has few guidelines for treatment. Author reviewed 14 cases of these fractures which were treated by open reduction and rigid internal fixation in Pusan National University Hospital from January 1983 to January 1993. In follow up study, Author obtained that good results in 10 cases(71%) of patient, and fair results in 3 cases of patient. Author advocate the patient with concomitant ipsilateral humerus and forearm bone fractures should requires open reduction and stable internal fixation of the both humerus and forearm bone, as soon as possible.

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Medullary fixation with rush pin of fracture of the forearm bone in adults: Young Chang Kim, Hae Ill Jung; J Korean Soc Fract 1991;4(2):340-346. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.340

Abstract PDF: No abstract available.

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