SURGICAL MANAGEMENT OF FRACTURE BOTH BONES FOREARM WITH LOCKING COMPRESSION PLATE IN ADULT PATIENTS

  • KRISHNA BHARGHAVA VEM Department of Orthopaedics, Apollo Institute of Medical Sciences and Research, Hyderabad - 500 096, Telangana, India.
  • SHIVA KUMAR CHALLA Department of Orthopaedics, Gandhi Medical College and Hospital, Musheerabad, Secunderabad - 500 003, Telangana, India.
  • SRINIVAS MURTHY D Department of Orthopaedics, Apollo Institute of Medical Sciences and Research, Hyderabad - 500 096, Telangana, India.

Abstract

Objective: The objective of this study was to assess the time taken for surgery, tourniquet time, and clinical outcome in diaphyseal fractures of both forearms managed with locking compression plate (LCP).


Methods: Patients underwent open reduction and internal fixation with 3.5-mm LCP. Proximal radius was approached by dorsal Thompson incision and middle and distal radius by volar henry approach. A minimum of 6 cortices were engaged with screw fixation in each fragment. Ulna was approached directly over the subcutaneous border.


Results: Of 20 patients, 70% were men; fracture was the most common in second and third decades of life. Road traffic accident (50%) and fall (40%) were the main causes. Fractures at mid-diaphysis (70%) and transverse/short oblique (72.5%) were the most common. Closed head injury, unilateral pubic bone fracture, olecranon fracture, fracture of both bones of leg, and ipsilateral fracture shaft humerus were the associated injuries. There was no intraoperative complication. Superficial infection (n=01) and transient posterior interosseous nerve injury, in the immediate postoperative period (n=01), were the reported complications. Average time for surgery was 77 min (60–90 min) and that for tourniquet was 54 min (40–60 min). All had complete union in <6 months; 80% had healing in <4 months. 20% healed in 4–6 months. Excellent and satisfactory results were seen in 85% and 15% patients, respectively.


Conclusion: The 3.5-mm LCP, when applied properly, yields excellent outcome in fractures of forearm bones. The use of tourniquet, separate incisions for radius and ulna, and preservation of the natural curves of radius will reduce complications. Clinical outcome in terms of healing and union is excellent.

Keywords: 0Diaphyseal fractures, Locking compression plate, Operation time, Tourniquet time.

Author Biographies

KRISHNA BHARGHAVA VEM, Department of Orthopaedics, Apollo Institute of Medical Sciences and Research, Hyderabad - 500 096, Telangana, India.

Assistant professor, Department of Orthopaedics 

Apollo Institute of Medical Sciences & Research, Apollo health city, Hyderabad, Telangana 500096. 

SHIVA KUMAR CHALLA, Department of Orthopaedics, Gandhi Medical College and Hospital, Musheerabad, Secunderabad - 500 003, Telangana, India.

Senior Resident, Department of Orthopaedics, 

SRINIVAS MURTHY D, Department of Orthopaedics, Apollo Institute of Medical Sciences and Research, Hyderabad - 500 096, Telangana, India.

Professor, Department of Orthopaedics

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BHARGHAVA VEM, K., S. KUMAR CHALLA, and S. MURTHY D. “SURGICAL MANAGEMENT OF FRACTURE BOTH BONES FOREARM WITH LOCKING COMPRESSION PLATE IN ADULT PATIENTS”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 12, no. 3, Feb. 2019, pp. 130-5, doi:10.22159/ajpcr.2019.v12i3.28801.
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