Elastic intramedullary nail for treating 22-A fracture in the forearm of adults / 中国组织工程研究

ABSTRACT

BACKGROUND: Elastic intramedullary nail is commonly used in the treatment of fractures of children, but few studies concern the elastic intramedullary nail for treating fractures in adults. OBJECTIVE: To investigate the repair effect of elastic intramedullary nail in the treatment of 22-A fracture in forearm of adults. METHODS: From January 2015 to April 2016, a total of 21 adult patients with the 22-A fracture (35 fractures) were treated with manipulative reduction and elastic intramedullary nail fixation in the First Affiliated Hospital of Guangzhou University of Chinese Medicine. The follow-up time was 12-18 months. Radiographs were taken and the guidance of the limb function training was given at regular intervals. The Andserson scoring system was used to evaluate the patients' forearm limb function. Fracture healing, elbow, wrist joint activity and forearm rotation were recorded. The satisfactory questionnaires were recorded. The patients were divided into three grades as satisfaction, general satisfaction and dissatisfaction; simultaneously, reasons were recorded. RESULTS AND CONCLUSION: (1) The Andserson scoring was satisfactory in 16 cases accounted for 76%, general satisfaction in 3 cases accounted for 14%, dissatisfaction in 2 cases accounted for 10%. (2) Wrist joint activity increased from (172±4)° before the operation to (181±3)° at the end of the follow-up. Elbow joint activity increased from (102±18)° before the operation to (124±13)° at the end of the follow-up. Forearm rotation activity increased from (84±11)° before the operation to (155±13)° at the end of the follow-up (P < 0.05). (3) In the follow-up of the 21 patients, 13 patients were satisfied with the result of surgery; 5 patients were generally satisfied; 2 patients were dissatisfied because the limited limb functions; and 1 patient was dissatisfied because of the nail irritability; the dissatisfaction rate accounted for 14%. (4) Elastic intramedullary nail can obtain affirmative effect in the treatment of adult 22-A fracture of the forearm; and clinical application should be based on the type of fracture.