Open AccessOUTCOME OF INTRAMEDULLARY NAILING OF PROXIMAL THIRD RADIUS FRACTURES IN ADULTS USING TALWALKAR SQUARE NAIL.
Author(s) -
Naved Ahmed F Ansari,
Pradeep Kothadia,
Raviraj Shinde,
Sandeep R. Biraris,
Eknath Pawar,
Dhiraj Sonavane
Publication year - 2020
Publication title -
international journal of medical and biomedical studies
Language(s) - English
Resource type - Journals
eISSN - 2589-8698
pISSN - 2589-868X
DOI - 10.32553/ijmbs.v4i7.1326
Subject(s) - intramedullary rod , medicine , surgery , forearm , ulna , posterior interosseous nerve , elbow , olecranon , palsy , alternative medicine , pathology
Background : In the management of Proximal Third Radius Fractures in Adults it is very important to take care of posterior Interosseous nerve, regain the length of the bones, maintaining the radial bow, good apposition, intact fracture haematoma and alignment without any malrotation, early mobilization of wrist and elbow to get good results. Intra medullary nailing of these fractures can be considered as a good alternative method. The aim of the study was to evaluate results of intramedullary nailing using Talwalkar square nails in adult forearm fractures.
Method: It’s a prospective multicentric study where we treated 92 adult patients with Proximal Third Radius Fractures, isolated or along with ulna fracture with over the period of four years may 2013 to may 2018 with a follow up for one years.
Result: The average time to complete union was 12.1 (SD +3.2) weeks with cast support for a mean of 8.5 weeks. Union was achieved in 88 out of 92 patients. Using the Grace and Eversmann rating system, 57 patients were excellent, 24 were good, and 7 had an acceptable result. Four patients had non-unions, 2 for the radius and two for the ulna. There were three cases of superficial infection, two had olecranon bursitis. Complication rates associated with the use of square nails were lower compared to plate osteosynthesis and locked intramedullary nails. To control rotation postoperatively, there is a need for application of an above-elbow cast after nailing. There were no incidences of Posterior Interrosseous Nerve injury
Conclusion: Use of Talwalkar’s design of the square nail has resulted in and continues to result in predictable and good results. Complication rates are lower as compared to plate osteosynthesis, although application of above-elbow cast after nailing is a downside of the procedure. The square nail still has a future in repair of forearm fractures considering its complications rates, cost and acceptable results.
Keywords: Proximal Radius fractures, square nail, Talwalkar Nail, closed intramedullary nailing, radius-ulna nailing