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Year : 1967  |  Volume : 1  |  Issue : 1  |  Page : 26-30

Treatment Of Simple Fractures Of Radius And Ulna With Internal Fixation And Without External Support

Correspondence Address:
A. K Talwalkar

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In majority of cases where both bones of the forearm are fractured the angulatory and rotational strains present difficulty not only in reduction but In majority of cases where both bones of the forearm are fractured the angulatory and rotational strains present difficulty not only in reduction but also in its maintenance. Therefore, these injuries, particularly in adults where the compensatory mechanisms of childhood are lacking, are difficult to treat. The results of conservative treatment may be good in a large number of causes, I believe, the final results is often disappointing. Out of the 41 cases reported by Knight and Purvis (1949) the results were satisfactory in only 29 percent, where the period of immobilisation was four and a half to five months. Twelve percent of these went into non-union. Bolton and Quinlan (1952) studied 92 patients and found that displacement occurred in fourteen and non-union in ten. Bose (1959) reported good results in 45 percent of adults in a series of 600 cases. Because of the consistently bad even after prolonged plaster fixation a method had to be found where early mobility of limb with minimum of disuse atrophy and shorter rehabilitation period could be made possible. In this paper it is shown that by the technique described the fractures of radius and ulna are no longer a formidable problem and good results can be achieved without long-term plaster immobilisation. This technique was evolved in stages since 1952 when the author had successively tried Kirschner and Lambrinudi wires, Rush and Kuntscher nails for the internal fixation of these fractures. Although the results of these trials were encouraging yet a number of drawbacks in their uses were observed. The author had noted with interest the good results reported by Sage in 1959 by using triangular nails which were pre-bent and properly tempered particularly for use in the radius. It was that solitary case, of an isolated fracture of radius where Sage used no external immobilisation and yet achieved perfect union, which gave the had author an impetus to use square nails, on the assumption that a square nail inserted in a round medullary cavity would provide sound fixation. Hence the plaster immobilisation could be discarded at a very early stage after surgery.

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