Outcomes Following Plate Fixation of Fractures of Both Bones of the Forearm in Adults

Author(s): Droll K, Perna P, Potter J, Harniman E, Schemitsch E, McKee M

Source: Bone Joint Surg 89A(12): 2619-24, 2007.

Summary:

This study is a retrospective review of 30 adult patients that underwent ORIF of a both bone forearm fracture with a mean follow-up of 5.4 years.  Patients with ipsilateral wrist or elbow injuries or contralateral both bone forearm fractures were excluded. Thirteen (43%) were open.  All evaluated fractures achieved union without infection with near anatomic alignment related to measurements of radial bow.  When compared to the uninjured arm, strength testing revealed diminished forearm pronation in 70%, supination  68%, grip 75%, wrist flexion 84%, and wrist extension 63%.  Active range of motion was also reduced in supination in 90%, pronation 91%, and wrist flexion in 82%.  The mean DASH score of 18.6 is significantly higher in the treatment group when compared to normative values (10.1). The level of pain correlated best with the DASH and SF-36.

ORIF of both bone forearm fractures is known to be a reliable operation with a high union rate.  This study demonstrated that although all fractures healed, range of motion and strength were persistently reduced by approximately 30% at long-term follow-up. In addition, patient perceived disability correlated best with their pain rather than with these objective physical findings.