[Intramedullary nailing in forearm shaft fractures--an 18 year retrospective study of a patient sample]

Between 1976 and 1993 we have operated 253 patients with 350 fractures of the radius-and/or ulna. 180 fractures were stabilized with a plate (ASIF) or external fixation. In 100 patients with 170 fractures Hackethal's bundle nailing was performed, including 23 times nailing of one bone and external fixation or plating of the other bone. Our indications for Hackethal's bundle nailing of forearm fractures are closed and 1 degree open A and B-fractures of the 2. to 5. sixth of the radius and/or the ulna. 83 of 100 patients, stabilized with bundle nailing, were followed up clinically and radiologically after a mean of 6.8 years. For evaluating follow-up results, the score by Oestern and Tscherne was employed. Very good and good results were found in 74.7%, satisfying and poor results in 25.2% of the cases. Injuries of the same extremity, e.g. fractures of the humerus, arterial- or nerve lesions interfered with the results. We found a low complication rate after bundle nailing: 1 osteomyelitis (0.59%), 3 non-unions (1.76%), 1 refracture (0.59%), 5 synostoses (4.12%, incl. 2 patients (1.18%) with a combination of bundle nailing and plate osteosynthesis or external fixation). In the mentioned indications the stabilization of forearm fractures by Hackethal's bundle nailing is a low-risk method with fast bone healing and short operation time.