Journal of Musculoskeletal Trauma

Review Article

Current concepts and applications of internal fixation for forearm diaphyseal fractures: Sung Yoon Jung, Min Kyun Cho, Dong-hee Kim, Sang Hyun Lee; Received January 30, 2026 Accepted May 11, 2026 Published online July 3, 2026; DOI: https://doi.org/10.12671/jmt.2026.00087 [Epub ahead of print]

Abstract PDF: Adult diaphyseal fractures of the forearm functionally behave as intra-articular injuries because forearm rotation depends on accurate restoration of length, axial alignment, rotation, and the native radial bow. This narrative review summarizes contemporary surgical options for adult forearm shaft fractures, including 3.5-mm plate osteosynthesis, dual mini-plate fixation, interlocking intramedullary nailing, and minimally invasive plate osteosynthesis (MIPO). Compression plating with 3.5-mm plates remains the reference standard for most fracture patterns, whereas other techniques should be regarded as selective, emerging, or salvage options according to their indication spectrum and evidence base. Mini-fragment dual plating may be useful for short segments or thin soft-tissue envelopes, although the supporting clinical evidence remains limited and meticulous biomechanical execution is essential. Interlocking intramedullary nailing is a viable alternative for carefully selected simple fracture patterns or soft-tissue-compromised situations, offering less invasive exposure but a narrower indication spectrum. MIPO may be considered for selected comminuted or soft-tissue-compromised diaphyseal fractures; however, its use in adult forearm fractures remains constrained by the high functional requirement for precise restoration of length, rotation, and the radial bow. To improve transparency, this review explicitly distinguishes established, evidence-supported methods from techniques supported mainly by limited retrospective data or institutional experience. A pattern-based pragmatic algorithm and expanded comparison table are provided to guide fixation selection according to the bone involved, fracture location, fracture morphology, soft-tissue condition, and evidence tier while minimizing complications such as nonunion, infection, nerve injury, refracture after plate removal, and radioulnar synostosis.

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Case Report

Major Limb Replantation of Lower Leg Amputation with Ipsilateral Distal Femoral Comminuted Fracture in Old Age: A Case Report: Tae Young Ahn, Seung Joon Rhee, Sang Ho Kwak, Hyo Seok Jang, Sang Hyun Lee; J Korean Fract Soc 2019;32(4):227-231. Published online October 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.4.227

Abstract PDF: The development of microsurgical techniques has also increased the success rate of replantation surgery. This paper reports the results of limb replantation performed on a lower extremity amputation that was associated with crush amputation and an ipsilateral comminuted fracture in and elderly patient. A 68-year-old female presented with a right distal tibia amputation due to a traffic accident. At that time, with a comminuted fracture in the distal femoral condyle, simple wound repair was recommended, but the caregivers strongly wanted replantation. Three years after surgery, normal walking was possible without a cane and the patient was satisfied with the function and aesthetics. What used to be contraindicated in limb replantation in the past are now indications due to the development of microsurgical techniques, surgical experience, and postoperative rehabilitation treatment. If the patient is willing to be treated, good results in contraindications can be obtained.

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