CURRENT CONCEPTS IN ADULTS UPPER EXTREMITY FRACTURES

21452Ugur_TiftikciCurrent_Consept_in_adults.kapak

SURGICAL TREATMENT OPTIONS FOR DIAPHYSEAL FRACTURES OF THE RADIUS AND ULNA

Mehmet Yılmaz1 İsmail Güzel2

1Gaziantep Islamic Science and Technology University, Faculty of Medicine, Ersin Arslan Training and Research Hospital, Department of Orthopedics and Traumatology, Gaziantep, Türkiye
2Malatya Turgut Özal University, Faculty of Medicine, Malatya Training and Research Hospital, Department of Orthopedics and Traumatology, Malatya, Türkiye

Yılmaz M, Güzel İ. Surgical Treatment Options for Diaphyseal Fractures of the Radius and Ulna. In: Tiftikçi U, Erdoğan E, Ergün C, Güneş Z, editors. Current Concepts in Adults Upper Extremity Fractures. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.243-251.

ABSTRACT

Throughout centuries, non-surgical treatments have dominated the management of forearm diaphyseal fractures. However, complications such as malunion or nonunion have been commonly observed with conservative treatment methods. Today, the primary treatment for radius-ulna shaft fractures in adults is surgical. Pronation and supination movements at the forearm level occur due to the sliding of the radius over the ulna. Deviations in the anatomical alignment of these bones, particularly at certain angles, lead to a loss of pronation and supination, which significantly affects hand functions. Therefore, radius and ulna diaphyseal fractures are classified as intra-articular fractures. The choice of surgical treatment depends on the patient’s general condition, age, the type of fracture, and whether it is open or closed. Surgical treatment options include cerclage fixation, external fixation, plate-screw fixation, and intramedullary fixation. Among these, the most widely accepted method is open reduction and internal fixation. Limited Contact Dynamic Compression Plate (LC-DCP) is the most commonly preferred implant used in plate osteosynthesis. Compared to open reduction and internal fixation, intramedullary nailing, which has started to be used as an alternative to plate osteosynthesis, has been shown to be superior in terms of operation time and healing time. However, no difference has been found between the two methods according to functional assessment criteria. The choice of surgical method or timing for open radius-ulna shaft fractures remains controversial. Today’s approach to managing open fractures leans towards internal fixation after immediate irrigation and adequate debridement, as long as the implants can be covered by soft tissues.

Keywords: Forearm diaphyseal fractures; Surgical treatment; Plate osteosynthesis; Intramedullary nailing

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