Intramedullary interlocking nailing fixation for forearm fractures: Kenyan experience: Initial report

Abstract

Objective: To evaluate treatment results of intramedullary fixation of radius and ulna diaphyseal fractures using interlocking nailing - system locked proximaly and distally by screws.

Methodology: Between December 2007 and May 2008, six patients (4 males and 2 females) with displaced diaphyseal forearm fractures underwent intramedullary fixation using interlocking nails. The nails were introduced into the ulna via a 1.5cm long incision at the tip of the olecranon splitting distal fibres of the triceps. The distal radius was entered via a 3cm longitudinal incision lateral to the Lister's tubercle. Locking for the proximal and distal radius and ulna was done with the forearm positioned appropriately. This produced a stable osteosynthesis and no casting was needed. Physiotherapy was started immediately and patient follow-up with check X-rays post-operation then at 6, 12 and 18 weeks. The time to union, functional recovery and complications was assessed.

Results: All the data was available for analysis. Nine fractures achieved stable osteosynthesis and proceeded to union by eight to twelve weeks. No infection was noted, and no neurological lesions were documented. The other two fractures have not yet united as we go to the press. Incidentally they were the compound Gustillo III fractures. Based on the Anderson criteria all the patients attained excellent results.

Conclusion: The newly introduced interlocking system for diaphyseal fractures of the forearm o'ffer a stable intramedullary fixation with excellent results. Further studies need to be done to confirm continuation of this good initial observation.