A PROSPECTIVE STUDY ON THE ROLE OF INTRAMEDULLARY NAILING IN ADULT DIAPHYSEAL FOREARM FRACTURES, DURING COVID-19 PANDEMIC, HYDERABAD, INDIA

Abstract

Background & objectives: Fractures of forearm bones may result in severe loss of function unless adequately treated. Intramedullary nailing is less traumatic than plate-and-screw xation along with preservation of fracture hematoma. Idea of primary bone healing was one of the reasons why intramedullary nailing became disregarded in favour of plate and screw xation. The COVID-19 pandemic caused surgeons, to re-evaluate their approach to surgical procedures given concerns over the risk of aerosolization of viral particles and exposure of operating room staff to infection. This study aims to analyse functional outcome and advantages of intramedullary nailing (Titanium ElasticNails, Square or Rush nails) in treatment of adult diaphyseal forearm fractures during the pandemic. Methods: A prospective study on 16 cases of closed simple diaphyseal forearm fractures in the age group of 20 to 60 years from April 2020 to Jan 2021 managed with intramedullary nailing. Results were evaluated based on mode of anaesthesia, operating time, blood loss, average union time, modied Grace and Eversmann scoring system for functional outcome. Interpretation and Conclusion: Most cases received brachial block with mean operating time of 40 minutes. Blood loss was minimal. The average union time (radiologic evidence of callus) was 7 weeks. Functional outcomes were excellent in 12 patients (75%), good in 3 patients (18.75%) and poor in 1 case. Intramedullary nailing is a reliable but less invasive alternative for adult diaphyseal forearm fractures during pandemics with excellent stability and predictable results.