Surgical treatment of open diaphyseal fractures of both the radius and ulna.

BACKGROUND This study was designed to determine the effects of surgical treatment of acute, open and displaced diaphyseal fractures of both the radius and ulna by early debridement, reduction and internal fixation with a dynamic compression plate (DCP). METHODS From 1991 to 2003, data from 25 patients with acute, open and displaced diaphyseal fractures of both the radius and ulna were collected and evaluated retrospectively. Twenty-four patients were managed with early surgical debridement, open reduction and internal fixation with a DCP, and 1 fracture was reduced and fixed 3 days after the initial injury. The mean follow-up period was 74.7 months (standard deviation [SD], 38.6 months; range, 16-150 months). All patients had complete functional and radiographic assessments. RESULTS Twenty-four patients (96%) achieved normal union in a mean of 20.2 weeks (SD, 3.8 weeks; range, 12-24 weeks). One patient with an open type I fracture had nonunion. Functional outcomes showed that 15 patients had excellent results, 8 had satisfactory results, 1 had an unsatisfactory result, and there was 1 failure. There was 1 delayed superficial wound infection. CONCLUSION Early meticulous debridement, good open reduction and internal fixation with a small DCP proved very effective in the management of type I and II open fractures of both the radial and ulnar diaphyses.