Clinical results of locking compression plate external fixation for open ulnar and radial shaft fractures

INTRODUCTION AND IMPORTANCE: Open ulnar and radial shaft fractures refers to the simultaneous rupture and injury of the skin and subcutaneous soft tissue at the fracture, and is easy to cause wound infection, local soft tissue necrosis or osteomyelitis. The purpose of this paper is to observe the efficacy of external locking compression plate in the treatment of open fractures, so as to provide reference for clinical practice. CASE PRESENTATION: From January 2019 to January 2020, 11 patients with open ulnar or radial shaft fractures underwent surgery by a single surgeon. Physical examination, radiography, and functional scores were performed before surgery and the average follow-up was 14 months (range, 12 to16 months) after surgery. Clinical outcome scores were recorded. Six patients obtained excellent Anderson Scores, four of satisfactory and one of Unsatisfactory. No surgical complications, reoperations, nonunion and implant breakage in this series and the fractures can be healed from 6 to 12 months after the operation. All implant removal was requested for all cases. CLINICAL DISCUSSION: Open ulnar and radial shaft fractures refers to the simultaneous rupture and injury of the skin and subcutaneous soft tissue at the fracture, which can connect the fracture site with the outside environment, and is easy to cause wound infection, local soft tissue necrosis or osteomyelitis. The open fracture mostly involves adjacent joints. If it is not treated in time, it is easy to lead to complications such as infection and nonunion. The locking plate is named as “internal fixation”, which means the internal fixation is placed in the soft tissue, and is similar to the external fixator. However, its biomechanical properties still need to be verified, the appropriate screw position and number need to be further defined, and there is a lack of clinical validation of large number of cases. CONCLUSION: In this study, locking compression plate externaI fixation for technology for the treatment of open ulnar and radial shaft fractures has the advantages of minimal trauma, simple operation, reliable fixation, fewer postoperative complications, and restored stability and function of forearm joints. LEVEL OF EVIDENCE: Level IV, therapeutic case series.