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Internal fixation of diaphyseal fractures of the forearm: a retrospective comparison of hybrid fixation versus dual plating.

OBJECTIVES: To compare open reduction and internal fixation using dual plating to a hybrid fixation construct with intramedullary nailing of the ulna and plate fixation of the radius in both-bone forearm fractures.

DESIGN: Retrospective comparison study.

SETTING: Level I trauma center.

PATIENTS: A total of 56 skeletally mature individuals treated surgically for acute both-bone forearm fractures between July 2005 and December 2009. Monteggia, Galeazzi, and pathologic fractures, patients treated with external fixation and patients with traumatic brain injuries were excluded.

INTERVENTION: Twenty-seven patients were treated with dual plate fixation, and 29 patients were treated using a hybrid fixation construct.

MAIN OUTCOME MEASURES: Time to union, range of motion as assessed using a Grace and Eversmann score, and presence of complications.

RESULTS: There was no significant difference in either time to union or Grace and Eversmann scores between the 2 groups. There was 1 nonunion in each of the 2 groups. Nine overall complications, outside nonunions, were reported: 5 in the dual plating group and 4 in the hybrid fixation group.

CONCLUSIONS: Hybrid fixation, using open reduction and internal fixation with a plate-and-screw construct on the radius and closed--or minimally open--reduction and interlocked intramedullary fixation of the ulna, is an acceptable method for treating both-bone diaphyseal forearm fractures in skeletally mature patients.

LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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