Epidemiology and Treatment Outcomes in Adult Peri-Implant Forearm Fractures: A Longitudinal Observational Study

Although forearm fractures in adults are commonly managed operatively, there is a paucity of studies on peri-implant fractures of the forearm.

We performed a single-centre retrospective cohort study. Consecutive patients presenting with peri-implant fractures of the forearm between 2010 and 2024 were included. In this study, we described the epidemiology of peri-implant forearm fractures, fracture configuration, treatment received, and outcomes following this injury.

Thirty-five patients were identified from our database. Median age at the time of injury was 39.5 years. The period prevalence was 7.7% (95% Confidence Interval (CI): 4.9-11.4). Fifteen cases (42.9%, 95% CI: 26.3-60.7) were associated with confirmed cases of domestic violence. Fractures occurred through either the proximal or distal screw in 64.3% of cases. Seventeen patients were managed operatively in the first instance, none of which experienced a complication. In the remaining 18 patients managed non-operatively, delayed or non-union was observed in four patients, necessitating further operative management in three patients. When we adjusted our findings for age, sex, Charlson Comorbidity Index, smoking, diabetes and presence of open injury, the increased odds of delayed/non-union was not statistically significant (Odds Ratio = 21.14, 95% CI: 0.51-874.03, p = 0.108).

The epidemiology of peri-implant forearm fractures within our patient population is greater than historic literature. As a substantial proportion of these injuries were sustained secondary to domestic violence, medical personnel should remain vigilant about the potential mechanisms behind the injury, especially if practicing in regions where there is a high prevalence of domestic violence.