Forearm Shaft Fractures: Results of Ten-year Follow-up

Fractures of the forearm present a unique management problem for years. Major improvements in the results of management of this injury awaited the development of advanced techniques. The introduction of AO implants and AO principles has markedly improved functional results for the patient, depending on the degree of soft tissue injury. Presentation is made of a ten-year follow-up of forearm fractures operatively treated at the Department of Surgery, Sestre milosrdnice University Hospital in Zagreb. The follow-up included 354 forearm fractures in 331 patients. Complete forearm shaft fractures were recorded in 121 (34%), fracture of the ulna alone in 130 (37%) and of the radius alone in 102 (29%) patients. Compound fractures occurred in 67 (19%) patients. All patients underwent operative treatment. Compound fracture was the indication for early operation in 85 (24%) patients. Internal fixation was performed by use of a narrow dynamic compression plate (DCP), mostly small DCP, and occasionally semitubular plate. Second and third degree open fractures were treated with external fixation. Postoperative plaster immobilization was employed in 39 patients for three to four weeks. Complications included infection (2.8%), nonunion (3.9%), refracture (1.4%), and synostosis (2.8%). Results of surgical treatment were considered excellent in 62%, good in 16%, satisfactory in 12%, and poor in 10% of patients.