Impact of Radial Bowing Alteration on Functional Outcomes Following Locked Intramedullary Nailing of Adult Both-Bone Forearm Fractures

Mehmed Nuri Tütüncü; Muhammed Muvahhid Sevgin; Salim Çağatay Akbulut; Fuat Akpinar

doi:10.18621/eurj.1828131

Impact of Radial Bowing Alteration on Functional Outcomes Following Locked Intramedullary Nailing of Adult Both-Bone Forearm Fractures

Abstract

Objectives: Plate osteosynthesis is the standard treatment for adult both-bone forearm fractures, but locked intramedullary nailing (IMN) offers a minimally invasive alternative. Its impact on restoring radial bow and functional outcomes is unclear. This study assessed changes in radial bow magnitude and location after IMN and their relationship with functional outcomes.

Methods: Twenty-six adult patients who underwent locked IMN for diaphyseal both-bone forearm fractures between 2015 and 2024 were retrospectively analyzed. Demographic data, radiographic measurements, union time, functional scores, and range of motion were recorded. Radial bow magnitude and bow apex location were measured on standardized radiographs and compared between the operated and contralateral forearms. Correlation analyses were performed to evaluate associations between bow changes and functional outcomes.

Results: All fractures achieved union, with no cases of nonunion or radioulnar synostosis. The mean time of union was 10.7±1.8 weeks. Extensor pollicis longus (EPL) rupture occurred in two (7.7%) patients. Postoperative radiographs showed reduced bow magnitude (Δ=0.61±1.13 mm; P=0.010) and a distal shift in bow location (Δ = –5.38±5.39%; P=0.001) on the operated side. A significant negative correlation was found between distal bow displacement and supination (r = –0.561; P=0.003). No correlation was observed with pronation, VAS, or QuickDASH scores.

Conclusions: Locked IMN ensures reliable union and excellent function. While IMN changes radial bowing, only excessive distal displacement impairs supination.

Keywords

Ethical Statement

The study was approved by the Göztepe Prof. Dr. Süleyman Yalçın City Hospital Non-Interventional Clinical Research Ethics Committee (Decision no.: 2025/0127 and date: 28.08.2025). All procedures performed during data collection, review of patient records, and study implementation complied with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its subsequent amendments. Written informed consent was obtained from all individual participants included in the study.

Thanks

We would like to express our sincere gratitude to Dr. Tolga Onay for his valuable advice, insightful comments, and meaningful contributions to the development of this study.

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Details

Primary Language

English

Subjects

Orthopaedics

Journal Section

Research Article

Authors

Mehmed Nuri Tütüncü ^*
0000-0002-0861-1477
Türkiye

Muhammed Muvahhid Sevgin
0009-0005-5424-5008
Türkiye

Salim Çağatay Akbulut
0000-0003-4737-757X
Türkiye

Fuat Akpinar
0000-0001-9399-8516
Türkiye

Early Pub Date

January 22, 2026

Publication Date

March 1, 2026

Submission Date

November 24, 2025

Acceptance Date

January 20, 2026

Published in Issue

Year 1970 Volume: 12 Number: 3

DOI

https://doi.org/10.18621/eurj.1828131

IZ

https://izlik.org/JA43YG66KN

Cite

RIS / Bibtex

AMA

1.Tütüncü MN, Sevgin MM, Akbulut SÇ, Akpinar F. Impact of Radial Bowing Alteration on Functional Outcomes Following Locked Intramedullary Nailing of Adult Both-Bone Forearm Fractures. Eur Res J. 2026;12(3):315-322. doi:10.18621/eurj.1828131