Functional Outcomes of Neglected Forearm Diaphyseal Fractures Treated Surgically: A Prospective Cohort Study

Cureus. 2022 Nov 2;14(11):e31035. doi: 10.7759/cureus.31035. eCollection 2022 Nov.

Abstract

Background Unlike other injuries, adult diaphyseal forearm fractures necessitate open reduction and internal fixation. Fixation requires special attention to regaining the pre-injury length of both bones, alignment, proper apposition, and restoration of the radial bow. Although there are not many studies on surgical results for forearm fractures that have initially received indigenous therapy, there are a few studies on the functional outcomes of surgery in forearm malunion and non-union. Our study aimed to investigate the functional outcomes of neglected forearm diaphyseal fractures treated by open reduction and internal fixation. Methodology A total of 14 patients who presented with neglected forearm fractures between November 1, 2014, and February 29, 2016, were included. All cases underwent open reduction and internal fixation along with bone grafting. The following parameters were recorded preoperatively and at the one-year follow-up: Disabilities of the Arm, Shoulder, and Hand (DASH) score, Grace-Eversmann score, grip strength, and lateral pinch. At the end of one year, the range of motion was assessed along with the radiological assessment of the radial bow and union. Results This study included 14 adult patients, nine men and five women, with a mean age of 37.92 years. There was a significant improvement in the DASH score. All fractures united clinically and radiologically with the mean time to union being 13.85 weeks (12-18). There was a statistically significant change in the range of motion, grip strength, lateral pinch, and restoration of the radial bow. Of the 14 patients, seven had Good outcomes on the Grace-Eversmann score and the rest had Acceptable outcomes. Conclusions Surgical intervention in neglected diaphyseal forearm fractures leads to a satisfactory outcome. This is revealed by significant subjective and objective improvement both clinically and radiologically.

Keywords: forearm; fracture; malunion; neglected; non-union.