The Elastic Bridge Plating of the Forearm Fracture: A Prospective Study

Rigid plate osteosynthesis with compression is still the treatment of choice for forearm fractures to gain anatomic reposition, provide proper rotation and avoid a bridging callus. Due to necessary operative dissection there is a serious risk for infection and malunion. Based on good clinical results with elastic bridge plating at femur, humerus and tibia, this technique was also started to be used for forearm fractures in our clinic in 1995. In a prospective study, 86 of 124 consecutive patients at the age of 35.2 ± 14.7 years with 129 diaphyseal fractures of the radius or ulna (AO: 37 type A, 36 type B, 13 type C) were analyzed between January 1998 and December 2003. All fractures were stabilized by bridge plating. Radiographic union and clinical outcome were documented. Of the 129, 122 diaphyseal fractures (94.5%) healed within 10.2 ± 3.4 weeks without complications (no nerve lesions, nonunion, synostosis callus). One re-osteosynthesis, one secondary lag screw, and five cancellous bone grafts were necessary before final healing. About 79.1% of the patients had a perfect clinical outcome; 17.4% had additional severe injuries of the same arm. Bridge plating without interfragmentary compression is a reliable surgical procedure even for forearm fractures with low risk of infection and nonunion.