Outcome of Dynamic Compression Plate for Displaced Diaphyseal Fractures of the Radius and Ulna in Adults

Abstract

Background: In adults displacement, angulation, rotation and comminution may be quite marked and closed reduction is often difficult or impossible to achieve.  Even if an acceptable position can be obtained, and a cast successfully applied, late slipping of the fracture is extremely common and difficult to treat with severe loss of function. Objective: To assess the fracture union and functional outcome of patients treated with stable internal fixation and early mobilization. Study Design: Prospective study. Setting: Orthopaedic surgery departments of Independent Medical College and Punjab Medical College Faisalabad. Study Period: Between January 2010 and December 2011. Method: The study group included 32 males and 14 females aged 14-60 years with unstable displaced fractures shaft radius, ulna or both.    Relevant history and x-rays of the forearm were taken.  We followed the inclusion and exclusion criteria.   All the cases were treated   with open reduction and internal fixation with 3.5mmsmall fragment dynamic compression plate and screws. The cases were followed for at least 6 months.  Patients  were  assessed  functionally  and radiologically and  results were graded according  to the  system  described  by    F.M. Marek et al (1961)  as  excellent, good,  fair  and  poor.  Results:   This prospective study was completed on 46 patients 32 were male and 14 were female. All fractures were united in acceptable alignment.  At final assessment excellent results were obtained in 31 (67.39%), good results in 8 (17.39%), fair in 4(08.69%) and poor in 3(06.53%) of the cases. Poor clinical out come was high in neglected and mishandled cases.  There was no implant breakage or failure or fracture adjacent to 3.5 mm small fragment DCP. Conclusion: Dynamic compression plate is an excellent fixation for displaced diaphyseal fractures of the forearm bones in adults.