Distal radius fracture fixation using volar plate: A comparative study evaluating the biomechanical behavior of uni and bicortical distal screws

Practical Method to Evaluate the Stiffness of Fractured Radius

“…On the other hand, for the biomechanical tests using synthetic radii, the variability in the measured stiffnesses could be related to the biomechanical apparatus. To ensure the improvement of the new biomechanical apparatus, the SD of measured stiffnesses using the new biomechanical apparatus was compared with those of previous studies (Hsiao et al [ 5 ]; Salas et al [ 6 ]; Yamazaki et al [ 7 ]; Zysk and Lewis [ 8 ]; Neder Filho et al [ 9 ]; Oh et al [ 10 ]), as shown in Table 2 . The SD of stiffnesses from the new biomechanical apparatus (i.e., ±15.3 N/mm) was significantly lower than those of previous studies, i.e., ±56 to ±112 N/mm for cadaver radii [ 5 , 6 , 7 ], and ±34 to ±274 N/mm for synthetic radii [ 8 , 9 , 10 ].…”

“…The drawings of the biomechanical apparatus for the compressive tests of the previous works (i.e., cadaver radii [ 5 , 6 , 7 ] and synthetic radii [ 8 , 9 , 10 ]) are shown in Figure 5 . Together with the descriptions of biomechanical apparatus given in the literature, it is speculated that the precise alignments between the applied compressive force at distal radius, the center line of radius, and the reaction compressive force at proximal radius of the previous biomechanical apparatus [ 5 , 6 , 7 , 8 , 9 , 10 ] may not be carefully considered. Therefore, the tested radii may be under the inconsistent combinations between compression, bending, and shear.…”

“…To avoid high variabilities in geometry and material properties, as well as to accommodate the special handling requirements of cadaver radii, the synthetic radius was designed to simulate structural and material properties of cadaveric radius, while providing the low variabilities in geometry and material properties, as well as fulfilling the simple handling requirements. Synthetic radii have frequently been used for the biomechanical tests of treated DRFs [ 8 , 9 , 10 ]. Although the variabilities in geometry and material properties of synthetic radii can be controlled, the high deviations of stiffness are surprisingly observed in these studies.…”

“…During biomechanical tests, pure compression without any bending and/or shear is expected. It is speculated that the high deviations of stiffness [ 8 , 9 , 10 ] may relate to the inconsistency of applied mechanical actions (i.e., the tested synthetic radii may be under the various combinations between compression, bending, and shear). In the present study, a biomechanical apparatus and an experimental procedure were proposed for the biomechanical tests of radii under pure compression.…”

Reproducibilidad de parámetros radiográficos para determinar el éxito quirúrgico de fracturas de radio distal

“…Actualmente, el uso de placas de bloqueo palmar ha aumentado de manera considerable en el tratamiento de fracturas intraarticulares e inestables del radio distal. 7,8 En pacientes con estas fracturas se evalúan por lo regular los siguientes parámetros radiográficos útiles para desarrollar planes de tratamiento y para determinar el éxito postquirúrgico y el pronóstico funcional de la reducción: varianza cubital, inclinación volar, inclinación radial, altura radial y escalón articular. 9,10 Por ejemplo, un acortamiento cubital significativo implica un aumento de transmisión de cargas hacia el lado radial; una pérdida de inclinación volar cambia la carga articular aumentando la incidencia de inestabilidad mediocarpiana; una disminución importante de la altura radial se relaciona con dolor y con menor rotación del antebrazo; y una incongruencia articular resultante de un mayor escalón articular se asocia con el desarrollo de artrosis.…”