Forearm Fractures
Conditions
Keywords
Diaphyseal forearm fractures in adolescents
Brief summary
evaluate and compare the clinical, and radiographic outcomes of 2.7 mm locking compression mini-plate osteosynthesis versus titanium elastic intramedullary nail (TEN) in the surgical management of diaphyseal fractures of both forearm bones in adolescent patients
Interventions
PROCEDUREOpen reduction and internal fixation
Group A (mini-Plate group): Open reduction and internal fixation (ORIF) using a 2.7 mm locking compression mini-plate (LCP) system.
PROCEDUREClosed or mini-open reduction and fixation
Group B (TEN group): Closed or mini-open reduction and fixation using titanium elastic nails (TENs).
Sponsors
Sohag University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
10 Years to 16 Years
Healthy volunteers
No
Inclusion criteria
1. Age: 10 to 16 years (at time of injury). 2. Fracture pattern: diaphyseal fracture involving both the radius or ulna. o Fracture location: Diaphysis defined as the segment between the proximal metaphyseal flare (distal to bicipital tuberosity for radius; distal to coronoid process for ulna) and the distal metaphyseal flare (within 3 cm of the distal physis). 3. Indication for surgery: Failure of closed reduction or unacceptable alignment after attempted closed reduction, defined as: * Angulation \> 15° in any plane (sagittal or frontal). * Translation \> 50% of bone diameter. * Bayonet apposition. * Open fracture (Gustilo type I). * Inability to maintain acceptable reduction after cast immobilization (loss of reduction). 4. Skeletal maturity: Open or partially open distal radial physis (assessed on preoperative radiographs).
Exclusion criteria
1. Open fracture Gustilo type II \& III. 2. Pathological fracture (secondary to bone cyst, tumor, osteogenesis imperfecta, etc.). 3. Neurovascular compromise requiring emergent exploration (e.g., acute compartment syndrome, pulseless limb after reduction). 4. Floating elbow (ipsilateral supracondylar humerus fracture + forearm fracture). 5. Monteggia or Galeazzi fracture-dislocation patterns 6. Metabolic bone disease (e.g., rickets, osteomalacia, renal osteodystrophy). 7. Neuromuscular disorder affecting upper extremity function (e.g., cerebral palsy, muscular dystrophy, brachial plexus injury). 8. Active infection at surgical site or systemic infection.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Functional outcome assessed using the Grace and Eversmann scoring system. | 6 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Radiographic Bone Union Time | 6 months | the time until bridging callus is visible across at least 3 of 4 cortices on standard AP and lateral X-rays |
Countries
Egypt
Contacts
CONTACTRamadan Moanes
PRINCIPAL_INVESTIGATORramadan moanes
Faculty of medicine, Sohag university
Outcome results
None listed