, Volume 30, Issue 1, pp 31–37 | Cite as

Le fratture esposte d’avambraccio

  • Antonio Medici
  • Luigi Meccariello
  • Giuseppe Pica
  • Giancarlo De Nigris
  • Gabriele Falzarano

Open forearm fractures


Open fractures of the forearm represent an urgent/emergency orthopaedic condition. They are not free of complications, which can lead to upper limb disabling outcomes or amputation. The traumatologist’s goal is to carry out a correct and anatomic osteosynthesis bearing in mind the type of lesion, the instruments used for the synthesis and the consequences of his therapeutic choices. The authors of this articles describe the state of the art of open forearm fractures.


Conflitto di interesse

Gli autori Antonio Medici, Luigi Meccariello, Giuseppe Pica, Giancarlo De Nigris e Gabriele Falzarano dichiarano di non aver alcun conflitto di interesse.

Consenso informato e conformità agli standard etici

Tutte le procedure descritte nello studio e che hanno coinvolto essere umani sono state attuate in conformità alle norme etiche stabilite dalla dichiarazione di Helsinki del 1975 e successive modifiche. Il consenso informato è stato ottenuto da tutti i pazienti inclusi nello studio.

Human and Animal Rights

Per questo tipo di studio non è richiesto l’inserimento di alcuna dichiarazione relative agli studi effettuati su esseri umani e animali.


  1. 1.
    Chung KC, Spilson SV (2001) The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg Am 26(5):908–915 CrossRefPubMedGoogle Scholar
  2. 2.
    Markolf KL, Lamey D, Yang S et al. (1998) Radioulnar load-sharing in the forearm. A study in cadavera. J Bone Jt Surg Am 80(6):879–888 CrossRefGoogle Scholar
  3. 3.
    Chekhovich GG (1997) Our experience with preserving the extremity in severe open fractures of the forearm. Ortop Travmatol Protez 6:33–35 Google Scholar
  4. 4.
    Müller ME, Koch P, Nazarian S, Schatzker J (1990) The comprehensive classification of fractures of long bones. Springer, Berlin CrossRefGoogle Scholar
  5. 5.
    Schemiling GJ, Rafijah, Zinar D (2009) Trauma orthopaedic knowledge update. Edizioni Minerva Medica, Torino Google Scholar
  6. 6.
    Kim PH, Leopold SS (2012) In brief: Gustilo-Anderson classification. Clin Orthop Relat Res 470(12):3624 CrossRefPubMedCentralGoogle Scholar
  7. 7.
    Johansen K, Hansen ST Jr (2015) MESS (Mangled Extremity Severity Score) 25 years on: time for a reboot? J Trauma Acute Care Surg 79(3):495–496 CrossRefPubMedGoogle Scholar
  8. 8.
    Herndl E, Henckel von Donnersmarck G, Hupfer W, Mühlbauer W (1989) Immediate functional reconstruction of the upper extremity after high voltage electric burns. Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir 853–858 Google Scholar
  9. 9.
    Smith AM, Urbanosky LR, Castle JA et al. (2002) Radius pull test: predictor of longitudinal forearm instability. J Bone Jt Surg Am 84-A(11):1970–1976 CrossRefGoogle Scholar
  10. 10.
    Schemitsch EH, Richards RR (1992) The effect of malunion on functional outcome after plate fixation of fractures of both bones of the forearm in adults. J Bone Jt Surg Am 74(7):1068–1078 CrossRefGoogle Scholar
  11. 11.
    Evans EM (1945) Rotational deformity in the treatment of fractures of both bones of the forearm. J Bone Jt Surg 27:373–379 Google Scholar
  12. 12.
    Pesenti S, Litzelmann E, Kahil M et al. (2015) Feasibility of a reduction protocol in the emergency department for diaphyseal forearm fractures in children. Orthop Traumatol Surg Res 101(5):597–600 CrossRefPubMedGoogle Scholar
  13. 13.
    Schulte LM, Meals CG, Neviaser RJ (2014) Management of adult diaphyseal both-bone forearm fractures. J Am Acad Orthop Surg 22(7):437–446 CrossRefPubMedGoogle Scholar
  14. 14.
    Mostafa MF (2013) Treatment of distal radial fractures with antegrade intra-medullary Kirschner wires. Strateg Trauma Limb Reconstr 8(2):89–95 CrossRefGoogle Scholar
  15. 15.
    Martin WN, Field J, Kulkarni M (2002) Intramedullary nailing of pathological forearm fractures. Injury 33(6):530–532 CrossRefPubMedGoogle Scholar
  16. 16.
    Rockwood CA, Green DF, Bucholz RW (eds) (2006) Rockwood and Green’s fractures in adults. Lipincott Williams & Wilkins, Philadelphia Google Scholar
  17. 17.
    Takeuchi N, Mae T, Hotokezaka S et al. (2011) A Gustilo type IIIB open forearm fracture treated by negative pressure wound therapy and locking compression plates: a case report. Fukuoka Igaku Zasshi 102(10):293–297 PubMedGoogle Scholar
  18. 18.
    Henle P, Ortlieb K, Kuminack K et al. (2011) Problems of bridging plate fixation for the treatment of forearm shaft fractures with the locking compression plate. Arch Orthop Trauma Surg 131(1):85–91 CrossRefPubMedGoogle Scholar
  19. 19.
    Schmittenbecher PP (2005) State-of-the-art treatment of forearm shaft fractures. Injury 36(Suppl 1):A25–A34 CrossRefPubMedGoogle Scholar
  20. 20.
    Wei SY, Born CT, Abene A et al. (1999) Diaphyseal forearm fractures treated with and without bone graft. J Trauma 46(6):1045–1048 CrossRefPubMedGoogle Scholar
  21. 21.
    Helber MU, Ulrich C (2000) External fixation in forearm shaft fractures. Injury 31(Suppl 1):45–47 CrossRefPubMedGoogle Scholar
  22. 22.
    Barbieri CH, Mazzer N, Mazer MR (1999) Use of a delayed cortical bone graft to treat diaphyseal defects in the forearm. Int Orthop 23(5):295–301 CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Hake ME, Young H, Hak DJ et al. (2015) Local antibiotic therapy strategies in orthopaedic trauma: practical tips and tricks and review of the literature. Injury 46(8):1447–1456 CrossRefPubMedGoogle Scholar
  24. 24.
    Fernandes MC, Peres LR, de Queiroz AC et al. (2015) Open fractures and the incidence of infection in the surgical debridement 6 hours after trauma. Acta Ortop Bras 23(1):38–42 CrossRefPubMedCentralGoogle Scholar
  25. 25.
    Jupiter JB, Ring D (1998) Operative treatment of post-traumatic proximal radioulnar synostosis. J Bone Jt Surg Am 80(2):248–257 CrossRefGoogle Scholar
  26. 26.
    Kasten P, Krefft M, Hesselbach J, Weinberg AM (2003) How does torsional deformity of the radial shaft influence the rotation of the forearm? A biomechanical study. J Orthop Trauma 17(1):57–60 CrossRefPubMedGoogle Scholar
  27. 27.
    Kim SB, Heo YM, Yi JW et al. (2015) Shaft fractures of both forearm bones: the outcomes of surgical treatment with plating only and combined plating and intramedullary nailing. Clin Orthop Surg 7(3):282–290 CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Ghobrial TF, Eglseder WA Jr, Bleckner SA (2001) Proximal ulna shaft fractures and associated compartment syndromes. Am J Orthop 30(9):703–707 PubMedGoogle Scholar

Copyright information

© Società Italiana Ortopedici Traumatologi Ospedalieri d’Italia 2016

Authors and Affiliations

  • Antonio Medici
    • 1
  • Luigi Meccariello
    • 2
  • Giuseppe Pica
    • 1
  • Giancarlo De Nigris
    • 1
  • Gabriele Falzarano
    • 1
  1. 1.U.O.C. Ortopedia e TraumatologiaAORN G. RummoBeneventoItalia
  2. 2.Dipartimento di Scienze Mediche Chirurgiche e Neuroscienze, Sezione di Ortopedia e TraumatologiaUniversità di SienaSienaItalia

Personalised recommendations