Treatment of both bone forearm fractures with 2.7 mm plates: a non-inferiority study
摘要
To determine the effectiveness of 2.7 mm plates in treating both bone forearm fractures (BBFFs) compared to the current gold standard of 3.5 mm fixation. More specifically, to determine if 2.7 mm plates are non-inferior to the current standard of 3.5 mm plates.
DesignRetrospective including patients from 2016–2021.
SettingSingle institution, level-1 trauma academic medical center.
Patients/participants77 patients met inclusion criteria, 58 patients underwent fixation with 3.5 mm plates and 19 underwent fixation with 2.7 mm plates.
InterventionPlate osteosynthesis with either 2.7 mm or 3.5 mm plate instrumentation.
Main outcome measureMaintenance of reduction and achievement of fracture union.
ResultsAmong 77 total patients, 19 received 2.7 mm plates and 58 received 3.5 mm plates. There was no difference in age and BMI between groups, but the 2.7 mm group had fewer males (47% vs 79%, p = 0.02). Primary end points of achievement of union (89.5% vs. 79.3%, p = 0.39) and maintenance of reduction (100% vs. 94.8%, p = 0.99), and secondary end points of implant removal (15.8% vs. 13.8%, p = 0.79), return to the operating room (OR) (5.3% vs. 5.2%, p = 0.63), and minor complications (0% vs. 6.9%, p = 0.99) were similar between the 2.7 mm and 3.5 mm groups.
ConclusionThis study challenges the current standard of ORIF using 3.5 mm plates for diaphyseal forearm fractures. 2.7 mm plating resulted in at least equivocal achievement of fracture union and thus may be more efficacious given previous studies showing lower refracture risks after implant removal.
Level of evidenceLevel III, retrospective cohort study.