European Journal of Molecular & Clinical Medicine

Abstract

Aim: The aim of the study was to determine relationship of the subjective, objective and radiographic method of treatment.
Material and methods: A prospective study was conducted in the Department of Orthopaedics Vardhman Institute of Medical Sciences, Pawapuri, Nalanda, India. from July 2015 to June 2016. Three methods of treatment were utilized: open reduction and internal fixation (ORIF), closed reduction and casting (CR), and external skeletal fixation with pins-in-plaster (PIP). The method of treatment was chosen by the attending surgeon based upon his experience and the type of injury.
Results: Overall, 80 percent of patients reported no pain, with no difference between patients with open and those with closed fractures. While 83 percent of patients treated with ORIF were pain free at their last examination, only 51 percent treated with CR and 49 percent treated with PIP were painless. Patients with isolated fractures were more often pain free than were those with associated injuries. There was no significant difference in the loss of forearm rotation between closed and open fractures: 65 percent of each group lost less than thirty degrees of forearm rotation. 71 percent of patients treated with ORIF lost less than thirty degrees of forearm rotation, while only 50 percent treated by CR and 29 percent by PIP lost less than thirty degrees. Union occurred in 89 percent of radius fractures and 92 percent of ulna fractures, with an average time to union of 16.3 weeks for the radius and 17.7 weeks for the ulna. Union was more frequent after closed than after open fractures. Overall, 60 percent of patients had less than twenty degrees combined malalignment of the radius and ulna on the final radiographs, with no difference between those patients with open and those with closed fractures.
Conclusion: we concluded that the fractures of the shafts of the radius and ulna were good to excellent regardless of the method of treatment chosen. Except for a longer time to union and a higher infection rate, the outcomes of open and closed fractures were very similar. The presence of associated injuries was a strong predictor of a compromised end result.