gms | German Medical Science

Objectives/Interrogation: Although open reduction and internal fixation (ORIF) by plating is the treatment of choice of diaphyseal fractures of the forearm, delayed union and non-union remain existing complications. The goal of our study was to analyze predictive factors for union time in these fractures.

Methods: We present a retrospective study on 55 patients with 86 diaphyseal forearm fractures (31 patients had both bone forearm fractures). Union times have been distributed into 2 groups (3 months or less, or more than 3 months) and then compared through a multivariate regression analysis and Fisher's exact tests in order to stress out a statistical correlation with patient demographics, fracture pattern and characteristics, associated injuries, type of fixation used, and quality of postoperative reduction.

Results and Conclusions: Overall 65.1% of the fractures achieved union within 3 months, and 34.9% did not. Among these last, 31.3% did achieve union in more than 3 months, and 4.6% had an established non-union.

The use of a locking plate was statistically associated with a higher chance of union within 3 months.

Moreover, the gap width in the fracture site on post-operative Xrays also appeared significantly correlated with union time.

None of the other parameters showed any correlation with union time.

The use of locking plates in ORIF of diaphyseal forearm fractures in adults increases the chance of achieving union within 3 months postoperatively, even though exempting from postoperative immobilization.

Furthermore, gap width in fracture site after reduction is qualitatively and quantitatively correlated with the probability of not achieving union within 3 months.