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A NEW TECHNIQUE IN THE TREATMENT OF RADIAL AND/OR ULNAR GUNSHOT FRACTURES BY MEANS OF MINIMAL EXPOSURE PLATING



Abstract

Radial and/or ulnar fractures caused by gunshots are common in our society. These fractures are often very comminuted, and surgical exposure of the fracture site may deprive previously viable bone fragments of a blood supply. We looked at a minimally invasive method of plating these fractures.

Two surgeons performed a percutaneous plating procedure on six consecutive patients with a diaphyseal gunshot of the radius and/or ulna. This type of fixation acts as an internal form of ‘external fixator’.

When this paper was prepared, five of the six patients had gone on to complete clinical and radiological union and the sixth was still under follow-up. The mean time to full union was 12 weeks. Mean pronation was 60° (20° to 80°) and mean supination 50° (10° to 70°). In all patients, full elbow and wrist movement was preserved. To date we have had no complications of nerve injury, sepsis or radioulnar synostosis.

This is a very limited series of patients, but it seems this method of treating gunshot injuries of forearm bones produces good results. The long-term effect on wrist function is difficult to predict.

The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at The Department of Orthopaedic Surgery, Medical School, University of Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193 South Africa