Anatomy of the Distal Brachioradialis and Its Potential Relationship to Distal Radius Fracture

S, Koh; Andersen, Clark R.; Buford, William L.; Patterson, Rita M.; Viegas, Steven F.

doi:10.1016/j.jhsa.2005.08.012

Cited by 51 publications

(36 citation statements)

References 14 publications

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“…The zone where the occurrence of Colles' fracture is expected starts proximal to the distal subchondral plate of the radius and extends 20-25 mm proximally, as the distance between the radial styloid process and the fracture localization was found by Spadaro et al (1994) to vary between 13 and 24 mm. Other studies reported 22 ± 4 mm (Eastell et al 1989) and 28 ± 6.1 mm (Koh et al 2006) for the same quantity. Furthermore, radial height measured between the articular surface of the distal radio-ulnar joint and the radial styloid process ranging from 10 to 13 mm (Goldfarb et al 2001).…”

Section: Introductionmentioning

confidence: 57%

Validation of an HR-pQCT-based homogenized finite element approach using mechanical testing of ultra-distal radius sections

Варга

Dall’Ara

Pahr

et al. 2010

Biomech Model Mechanobiol

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Osteoporotic (Colles' type) fractures of the distal radius occur relatively early in lifetime and could estimate risk of fracture of other, more endangered anatomical sites. High-resolution peripheral quantitative computed tomography (HR-pQCT) based micro finite element (μFE) analysis was shown to better predict fracture load of the distal radius than densitometry or histomorphometric measures. As an alternative to μFE, homogenization-based FE (hFE) approach may provide at least equivalent predictive power with reduced computational needs. The aim of this study was to validate the hFE approach with compression tests of 25 distal radius sections extracted at the location which is relevant in Colles' fractures. HR-pQCT-based input parameters of the hFE models were calibrated with respect to μCT. HR-pQCT-based hFE models were then built and their ability to predict experimental stiffness and ultimate load was compared to those of the density-based parameters, histomorphometric indices and μFE models assessed from the same input images. Bone mineral content was the best non-FE-based predictor (R (2) = 0.86) of ultimate force. Both FE methods were not only the strongest predictors, but provided quantitatively correct fracture loads. The calibrated hFE approach provided closely as strong prediction (R (2) = 0.94) as μFE (R (2) = 0.95), but the former was computationally cheaper. The results of this validation study suggest that FE simulation could be used as an efficient and precise tool to predict Colles' fracture load.

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Section: Introductionmentioning

confidence: 57%

Validation of an HR-pQCT-based homogenized finite element approach using mechanical testing of ultra-distal radius sections

Варга

Dall’Ara

Pahr

et al. 2010

Biomech Model Mechanobiol

View full text Add to dashboard Cite

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“…There are significant changes in radiocarpal stress concentration and distribution with malalignment of the distal radius [8,9]. Malalignment of the distal radius can also lead to distal radio-ulnar joint incongruity, limiting forearm rotation [8][9][10][11][12][13]. In an early retrospective review of 565 distal radius fractures, Cooney and colleagues [4] found that malunion was frequently associated with pain, limited range of motion, and decreased strength.…”

Section: Nonoperative Managementmentioning

confidence: 99%

“…Significant indirect deforming forces across the fracture include the long flexor and extensor tendons. Deforming forces directly influencing fracture fragments include the brachioradialis, which has a consistent pattern of insertion on the radial side of the styloid and may contribute to the secondary displacement of this fragment [11].…”

Section: Follow-up and Aftercarementioning

confidence: 99%

Distal Radius Fractures: Nonoperative and Percutaneous Pinning Treatment Options

Gofton

Liew

2007

Orthopedic Clinics of North America

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“…6,12-14 The relationship between the distal attachment of the brachioradialis and the "radial beak" pattern of distal radius fractures was seen in 51% of patients in Koh's series. 13 However, the relationship is difficult to assess reliably on intraoperative or postoperative radiographs due to comminution of the radial aspect of the fracture line, variability of the radial flare, and obscurity caused by the overlying fixation plate. Due to the deforming force of the brachioradialis on the distal fracture fragment, release of its tendinous insertion has been advocated to aid open reduction, as closed reduction is usually not possible (►Fig.…”

Section: Discussionmentioning

confidence: 99%

Defining Residual Radial Translation of Distal Radius Fractures: A Potential Cause of Distal Radioulnar Joint Instability

et al. 2014

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Background The aim of this paper is twofold: to raise awareness of the potential problems of leaving residual radial translation of the distal fragment in distal radius fracture fixation and to provide a reproducible, accurate and simple radiographic parameter to define this reduction. The primary goal of all of this is to raise awareness of the malreduction to decrease problems with distal radial ulnar joint instability and to decrease the incidence of what the Authors consider to be unnecessary surgery on the ulnar side of the wrist when the surgeon is confronted with distal radio ulnar joint instability after fixation of a distal radial fracture. The idea is to make the surgeon look at reduction of the radius instead of fixing the ulnar side. We know that in the overwhelming majority of cases in our clinical experience, intraoperative correction of this deformity has avoided the need for ulnar styloid or TFC repair, which we otherwise would have performed had we not been aware of this malreduction. We have deliberately used the word potential in the title to reflect that we are proposing a hypothesis, and that only 40-50 percent of patients have a discrete distal band of the IOM. We have extensive experience over a 15-year period with internal fixation of distal radius fractures and have clearly observed this phenomenon. It is our belief, therefore, that we should be able to present this hypothesis in tandem with the radiographic parameter that we are advocating, to raise awareness of this malreduction of the radius. The radiographic parameter has little relevance unless put into this context. We would consider that the impact and value of this paper would be substantially weakened by removing this component of the title. Patients and Methods In this study, 100 normal wrist radiographs were reviewed by three fellowship-trained orthopedic surgeons to develop a simple and reproducible technique to measure radial translation.

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Anatomy of the Distal Brachioradialis and Its Potential Relationship to Distal Radius Fracture

Cited by 51 publications

References 14 publications

Validation of an HR-pQCT-based homogenized finite element approach using mechanical testing of ultra-distal radius sections

Validation of an HR-pQCT-based homogenized finite element approach using mechanical testing of ultra-distal radius sections

Distal Radius Fractures: Nonoperative and Percutaneous Pinning Treatment Options

Defining Residual Radial Translation of Distal Radius Fractures: A Potential Cause of Distal Radioulnar Joint Instability

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