Intramedullary nail fixation for the treatment of simple forearm fractures in military combatants

Abstract Background: Most of forearm fracture in military combatants are simple fracture. The traditational procedure for adult forearm fracture is open reduction and plate osteosynthesis. However, plate fixation do have the defect of nonunion, stress shielding, skin irritation. Intramedullary nail is believed to be an alternative treatment of adult forearm fractures. However, whether simple forearm fractures in military combatants could be successfully treated by intramedullary nail is not clear.Methods: Patients of military combatants with diagnosis of simple forearm fracture treated by intramedullary nail fixation were identified from 1st January 2016 to 31st November 2018 in this retrospective study. General information of the patients, time of follow-up, time of fracture union post-operation, complications, rotation activity and DASH score 12 month post-operation were recorded to figure out the clinical outcome of simple forearm fracture treated by intramedullary nail in military combatants.Outcome: Twenty male patients were identified in this retrospective study, with average age of 26.5 years old (range 18-36).Fourteen forearm fracture happened in right side and the rest six happened in left side. Single ulna fracture happened in 11 cases, single radius fracture happened in 4 cases , both forearm fracture happened in 5 cases. Classifications of the 20 patients were all OTA type A. All 20 patients got followed, with mean follow-up time of 15.8 months（range 12-18). All patients got fracture union successfully. Average time of fracture union was 2.6 months（range 2-4months）. Partially rupture of extensor pollicis longus tendon happened during operation in one patient and 3 months post-operation in another patient. One patient with both forearm fractures showed linear ossification of interosseous membranes. Average pronation activity 12 months post-operation was 86.9 degrees (range 80-90), average supination activity 12 months post-operation was 86.3 degrees (range 60-90). Average DASH score 12 months post-operation was 6.5（range 0-37).Conclusion: This respective study demonstrated that intramedullary nail achieved excellent results in the treatment of simple fracture of forearm in military combatants.Trial Registration : Not applicable