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PROXIMAL FRACTURES OF THE FOREARM: SURGICAL TREATMENT



Abstract

Purpose of the study: The outcomes of different stabilization methods for unstable forearm fractures are described.

Material and methods: From January 1980 through December 2000, 29 patients were treated at the central military hospital orthopedics uint for proximal forearm fractures, 27 underwent surgery. We used the Beaufils classification, depending on the localization of the ulnar fracture. Type 1: metaphyseal fracture (n=12) with dislocation of the radial cup; type 2: epiphyseal fracture with transolecraneal dislocation (n=6); type 3: metaphyso-epiphyseal fracture with anterior dislocation (n=5); type 4: metaphyso-epiphyseal fracture with posterior dislocation (n=5).

Results: Outcome was assessed at six months to 20 years follow-up. According to the Morrey classification, outcome was excellent for six patients, good for nine, fair for seven and poor for three. Six patients had a stiff joint, one had a synostosis and three nonunion.

Conclusion: To achieve satisfactory outcome, it is crucial to achieve internal fixation of the proximal ulna and reconstruction of the radial length. Resection without replacement of the radial cup is contraindicated in these associated fractures.

Correspondence should be addressed to SOFCOT, 56 rue Boissonade, 75014 Paris, France.