الفهرس 
PATIENTS AND METHODSOnly 14 pages are availabe for public view
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Abstract
Objective: The aim of the study is to compare the clinical and radiological outcomes of the hybrid method of fixation by using its two types, hybrid 1(plate ulna and ESIN radius) and hybrid 2 (plate radius and ESIN ulna), versus dual plating in diaphyseal both bone forearm fractures in adolescents aged 10 to 14 years.
Methods: A single-center, retrospective cohort study was conducted at an academic Level 1 Trauma Center. Patient data was collected from medical records, from June 2019 to June 2022. A total of 31 patients (aged 10-14 years) with both bone forearm diaphyseal fractures were recruited and divided into 2 major groups: the hybrid fixation group by its two types, and the dual plating group. Intraoperative blood loss and operative time were assessed and patients were followed up radiologically for the union as well as assessed clinically using the Price functional grading system at the final follow-up.
Results: The hybrid fixation construct group had 15 patients with a mean age of 13 years, and the dual plating group had 16 patients with a mean age of 13 years. There was no statistically significant difference between groups as regards gender, injured side, delay before surgery, mode of trauma, comorbidities, and associated injuries. The mean operative time in the hybrid group was (60 ± 7) minutes, and in the dual plating group was (82± 8) minutes, with a highly statistically significant difference between both major groups (P<0.001). The mean blood loss in the hybrid group was (67±15) ml and in the dual plating group was (101±10) ml, with a highly statistically significant difference (p<0.001). There was no statistically significant difference in either time to union (for radius P = 0.449, and for ulna P = 0.156) or results of the Price grading system (P = 0.901) between both major groups. Complication rates were also similar between both major groups.
Conclusion: Hybrid fixation by its two types is not only a considerable alternative to dual plating in the treatment of both bone forearm fractures in adolescents aged 10 -14 years that achieves the same rate of union, functional outcomes, and complication rates, but also at the same time has the advantage of short operative time and minimal blood loss. The use of hybrid 1 (plate ulna and ESIN radius) in proximal and middle third diaphyseal fractures, and hybrid 2 (plate radius and ESIN ulna) in distal third diaphyseal fractures are considered an attractive alternative to dual plating in this age group.
Keywords: Both bone forearm fracture, Hybrid fixation, Dual plating, Adolescence.