FRACTURES OF THE FOREARM

An Analysis of 415 Cases with Special Reference to Disabilities

A review of the results of 415 fractures of the forearm has been presented. The cases were consecutive and give a fair picture of what may be encountered in such a series. Many interesting facts have been revealed, namely:

In most instances these fractures heal well, without residual physical disabilities, and the patients can return to their former occupations. The time lost varies with the location and nature of the fracture, complications, and the occupation and age of the patient. In children the healing is much more rapid than in adults.

The longest periods of disability have been in fractures of both bones in the middle, upper, and lower thirds, the middle third of the radius and the middle third of the ulna, and in late resections of the head of the radius. On account of the frequency of serious complicating injuries (19.4 per cent. of all cases in this series) due consideration must be given to them. Although operative interference was necessary only in the more severe cases, good results and good union were secured in 87 per cent. of the cases.

The length of time required in securing union in the cases operated upon was generally longer than in those treated by the closed method.

Fractures in the lower third of the forearm, comprising 66.7 per cent. of the total number in this series, heal rapidly and yield good results. This is especially true in the Colles' area, with the exception of the comminuted fracture which occasionally is still a real problem.

Fractures in the middle third of the forearm, 14.7 per cent. of the total number, present more of a problem, as indicated by poorer results and longer periods of disability. These probably can be improved by better reductions and after-treatment.

Fractures in the upper third of the forearm, comprising 18.5 per cent. of the total number, are chiefly those of the olecranon and the head of the radius.

Displaced olecranon fractures are surgical problems and give excellent results.

In non-displaced fractures of the head of the radius, good results are obtained with conservative treatment. In displaced fractures in this location, early resections give the best results.

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