Between 1975 and 1983, fifty-seven patients were treated at Sunnybrook
and Harborview Medical Centers with immediate internal plate fixation of an
open diaphyseal fracture of the forearm. Fifty patients were available for
follow-up, which ranged from one to nine years and averaged three years.
The injuries were classified on the basis of the extent of soft-tissue
injury as defined by Gustilo and Anderson, and consisted of twenty Type-I
injuries, nineteen Type-II injuries, and eleven Type-III injuries. The
complications included deep infection in two patients and non-union in six.
The functional results were excellent or good in 85 per cent of the series.
This study demonstrates that immediate stable plate fixation is a
beneficial method of treatment of open fractures of the forearm. The
results are related to the severity of the initial soft-tissue injury and
the surgical technique. Autogenous cancellous bone-grafting at the time of
closure of the wound in comminuted fractures in which interfragmental
compression cannot be obtained is recommended.