Paper #I-3

FUNCTIONAL OUTCOME AND STRENGTH FOLLOWING PLATE FIXATION OF FRACTURES OF BOTH BONES OF THE FOREARM

Kurt P. Droll, MD, MSc

Toronto, ON

Co-Authors

Philip Perna, BSc

Alison McConnell, MSc (Eng)

Introduction

The purpose of this study was to investigate patient-based functional outcome and objectively measure strength following plate fixation of fractures of both bones of the forearm.

Methods

Twenty-five subjects (M/F 19/6, mean age 47.6 (range 20-71)) were clinically and radiographically reviewed. Mean duration of follow-up was 5.7 years (range 2-13.4 y). Isometric muscle strength was objectively measured with the Baltimore Therapeutic Equipment work simulator (model WS-20, Hanover, Maryland).

Results

Strength of elbow flexion (72% of non-injured arm, p<0.0001), elbow extension (84%, p=0.0004), forearm supination (75%, p=0.005), forearm pronation (69%, p<0.0001), wrist flexion (81%, p=0.009), wrist extension (62%, p<0.0001) and grip (70%, p<0.0001) were all significantly reduced in the injured arm. Mean (+/- SE) DASH and Gartland-Werley scores were 19.5 +/- 4.0 (range 0-61) and 4.04 +/- 0.91 (range 0-15) respectively. No statistical difference in mean maximal radial bow (MRB) between injured and non-injured arm was found (mean +/- SE, 1.42 +/- 0.07 vs 1.58 +/- 0.05 respectively) or in location of MRB (61% vs 59%).

Conclusion

Anatomic reduction was associated with good to excellent functional outcome scores. However strength of the elbow, forearm, wrist and grip were significantly reduced in the injured arm, and is an area for potential improvement in post-operative care.