Abstract
Objectives/Hypotheses: (a) To determine the radiographic correlation between an artificially created dorsal comminution (via a wedge osteotomy) and dorsal tilt (clinical instability) and (b) to determine the efficacy of cast immobilization in maintaining reduction of the simulated fracture pattern as a predictor of successful treatment in the clinical setting. Study Design: Biomechanical cadaveric study. Setting: Level I trauma center. Methods: In ten fresh cadaveric upper extremities, sequential dorsal wedge osteotomies (25, 50, and 75 percent of the distal radial diameter) were performed, each followed by measurement of tilt and radial inclination on posteroanterior and lateral radiographs before and after applying a load simulating the physiologic static forces of the forearm. In the last five specimens, the osteotomies were reduced and casted after the load application for each osteotomy, and radiographic measurements were again taken under loaded and unloaded conditions. Results: In the uncasted loaded group (n = 10), average tilt changed from an initial 9 degrees palmar to 3 degrees palmar after the first osteotomy and became dorsally angulated (11 and 30 degrees) after the second and third osteotomies, respectively. Casting and loading resulted in a palmar tilt of 10, 6, and 3 degrees for the 25, 50, and 75 percent osteotomies, respectively. Conclusion: Increasing wedge osteotomies across the midline axis of the radius resulted in dorsal tilt and radial inclination changes representative of clinically unstable fractures that require more aggressive treatment protocols. However, in our experimental setting, casting maintained reduction of stable and unstable osteotomy patterns.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 46-50 |
| Number of pages | 5 |
| Journal | Journal of Orthopaedic Trauma |
| Volume | 12 |
| Issue number | 1 |
| State | Published - Jan 1998 |
| Externally published | Yes |
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Keywords
- Biomechanics
- Casting
- Comminution
- Distal radius fracture
- Fracture stability
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
- Surgery
- Physical Therapy, Sports Therapy and Rehabilitation
Cite this
Biomechanical Evaluation of Distal Radius Fracture Stability. / Zmurko, Matthew G.; Eglseder, W. Andrew; Belkoff, Stephen M.
In: Journal of Orthopaedic Trauma, Vol. 12, No. 1, 01.1998, p. 46-50.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Biomechanical Evaluation of Distal Radius Fracture Stability
AU - Zmurko, Matthew G.
AU - Eglseder, W. Andrew
AU - Belkoff, Stephen M
PY - 1998/1
Y1 - 1998/1
N2 - Objectives/Hypotheses: (a) To determine the radiographic correlation between an artificially created dorsal comminution (via a wedge osteotomy) and dorsal tilt (clinical instability) and (b) to determine the efficacy of cast immobilization in maintaining reduction of the simulated fracture pattern as a predictor of successful treatment in the clinical setting. Study Design: Biomechanical cadaveric study. Setting: Level I trauma center. Methods: In ten fresh cadaveric upper extremities, sequential dorsal wedge osteotomies (25, 50, and 75 percent of the distal radial diameter) were performed, each followed by measurement of tilt and radial inclination on posteroanterior and lateral radiographs before and after applying a load simulating the physiologic static forces of the forearm. In the last five specimens, the osteotomies were reduced and casted after the load application for each osteotomy, and radiographic measurements were again taken under loaded and unloaded conditions. Results: In the uncasted loaded group (n = 10), average tilt changed from an initial 9 degrees palmar to 3 degrees palmar after the first osteotomy and became dorsally angulated (11 and 30 degrees) after the second and third osteotomies, respectively. Casting and loading resulted in a palmar tilt of 10, 6, and 3 degrees for the 25, 50, and 75 percent osteotomies, respectively. Conclusion: Increasing wedge osteotomies across the midline axis of the radius resulted in dorsal tilt and radial inclination changes representative of clinically unstable fractures that require more aggressive treatment protocols. However, in our experimental setting, casting maintained reduction of stable and unstable osteotomy patterns.
AB - Objectives/Hypotheses: (a) To determine the radiographic correlation between an artificially created dorsal comminution (via a wedge osteotomy) and dorsal tilt (clinical instability) and (b) to determine the efficacy of cast immobilization in maintaining reduction of the simulated fracture pattern as a predictor of successful treatment in the clinical setting. Study Design: Biomechanical cadaveric study. Setting: Level I trauma center. Methods: In ten fresh cadaveric upper extremities, sequential dorsal wedge osteotomies (25, 50, and 75 percent of the distal radial diameter) were performed, each followed by measurement of tilt and radial inclination on posteroanterior and lateral radiographs before and after applying a load simulating the physiologic static forces of the forearm. In the last five specimens, the osteotomies were reduced and casted after the load application for each osteotomy, and radiographic measurements were again taken under loaded and unloaded conditions. Results: In the uncasted loaded group (n = 10), average tilt changed from an initial 9 degrees palmar to 3 degrees palmar after the first osteotomy and became dorsally angulated (11 and 30 degrees) after the second and third osteotomies, respectively. Casting and loading resulted in a palmar tilt of 10, 6, and 3 degrees for the 25, 50, and 75 percent osteotomies, respectively. Conclusion: Increasing wedge osteotomies across the midline axis of the radius resulted in dorsal tilt and radial inclination changes representative of clinically unstable fractures that require more aggressive treatment protocols. However, in our experimental setting, casting maintained reduction of stable and unstable osteotomy patterns.
KW - Biomechanics
KW - Casting
KW - Comminution
KW - Distal radius fracture
KW - Fracture stability
UR - http://www.scopus.com/inward/record.url?scp=0031601028&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031601028&partnerID=8YFLogxK
M3 - Article
C2 - 9447518
AN - SCOPUS:0031601028
VL - 12
SP - 46
EP - 50
JO - Journal of Orthopaedic Trauma
JF - Journal of Orthopaedic Trauma
SN - 0890-5339
IS - 1
ER -