Purpose
A biomechanic study using a cadaver model of a dorsally unstable distal radius fracture
was used to compare the stability of percutaneous pinning and volar fixed-angle plating.
Among the many surgical options for treating distal radius fractures are percutaneous
pinning and internal plate fixation. Although percutaneous pin fixation requires less
soft-tissue trauma and has low complication rates, plate fixation allows for early
active movement with good clinical results. The biomechanic stability of these 2 methods
was studied by using a cadaver model of a dorsally unstable intra-articular distal
radius fracture.
Methods
This study was performed on 7 fresh-frozen cadaver arms, in each of which an unstable
intra-articular fracture with dorsal comminution was created. The fracture was first
fixed with 0.062-mm K-wires inserted in standard crossed fashion and was tested in
a pneumatic loading device that indirectly loaded the wrists through the 5 motor tendons
3 times at each level of force in flexion and extension. Testing was then repeated
after removal of the pins and fixation with a fixed-angle DVR distal volar radius
plate system (Hand Innovations, Inc., Miami, FL). Testing was performed in flexion
up to 68 N and in extension up to 100 N, and the distance across the fracture site
was measured.
Results
Volar plating was significantly more stable than pinning, with an average movement
across the fracture site of 2.51 mm for pin fixation and 1.07 mm for plate fixation.
The pins also showed a substantial degree of slipping after repeated stressing, but
the plates remained stable.
Conclusions
These results show the superior biomechanic stability of internal fixation using plates
for dorsally comminuted intra-articular distal radius fractures in this cadaver model.
Further clinical correlations are needed.
Key words
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Article info
Publication history
Accepted:
March 22,
2007
Received:
August 3,
2005
Footnotes
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Identification
Copyright
© 2007 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
