[Intramedullary nailing of fractures of forearm in adults.]

The authors present a three-year retrospective group of 32 adult patients with the diaphyseal fractures of the forearm treated surgically. Only in 3 cases a standard plate technique was used. All other surgeries were performed by intramedullary nailing using Prevot nails, strong Kirschner wires, True/Flex flexible nails and a bilaterally locked Foresight nail. Long-term results were in detail evaluated in a group of 15 patients with the implanted True/Flex nail. Minimum period of the follow-up was 6 months after operation, the average was 14,7 months. The nailing of both bones of the forearm with the use of a traction frame took on average 48 minutes. During the nailing there occurred 5 complications. Once a protruding tip of the nail was left in the region of the wrist, twice the fractured radius remained distracted, once there occurred "jamming" of the nail necessitating its shortening and once the tendon of the finger extensor was injured. No early postoperative complications were recorded. Of late complications only one case resulted in the development of a malunion in the patient who had a combination of True/Flex nail with K-wire. After the replacement of K-wire by a True/Flex nail the malunion quickly healed. We did not record any radioulnar synostosis, migration or bending of the implant or any late postoperative infection. All fractures healed. The nails were removed only in 5 cases, on average 10,2 months after the surgery. Further, the work summarizes technical conditions and surgical methods of nailing and compares individual sets of instruments and implants which are at present available. Among the advantages of the intramedullary nailing as compared to the plate technique is the miniinvasive method, shorter duration of the surgery, minimal blood loss, a small risk of infection, faster healing of fractures and a small percentage of complications. Key words: intramedullary nailing, forearm, adult.