Distal radius anatomy applied to the treatment of wrist fractures by plate: a review of recent literature

Obert, L.; Loisel, François; Gasse, N.; Lepage, D.

doi:10.1051/sicotj/2015012

Cited by 37 publications

(32 citation statements)

References 16 publications

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“…loaded, in axial compression, to a maximum load of 100 N, simulating the loading experienced at the distal radius during active gripping [20] [21] [22]. Each construct was then subjected to a quasi-static loading (between 50 N and 100 N, for 5000 cycles, at a rate of 2 Hz), which simulates the loading experienced at a surgically-treated fractured DRF during a 6-week healing period or is imposed during exercises carried out as part of a physical therapy regimen after surgery [20] [21] [23].…”

Section: Testing Methods and Loading Protocolmentioning

confidence: 99%

Biomechanical Comparison of Prototype of a Novel Intramedullary Injectable Bioresorbable Polymer-Bioresorbable Balloon Osteosynthesis and a Volar Locking Plate for Treatment of Distal Radius Fractures

Zysk¹,

Lewis²,

Taxier³

et al. 2017

WJET

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Background: There is a large assortment of modalities for the surgical treatment/management of distal radius fractures (DRFs), where the most widely used is the fixed-angle volar plating (VLP) system, which, sometimes, is referred to as the "surgical modality of choice". While outcomes with each modality are usually good to excellent, each has its share of shortcomings and complications. Thus, there is scope for improvements to existing modalities and/or introduction of new ones. Study Purpose: We introduce a novel modality, namely, the prototype of an intramedullary injectable bioresorbable polymer-bioresorbable balloon osteosynthesis (IPBO) system, and investigated its plausibility. Experimental Procedures: The biomechanical performance of a construct comprising a synthetic distal radius (fourth-generation Sawbones ® ) on which a simulated fracture was created (4-mm wide osteotomy positioned 25 mm from the most distal end of the radius) and fixated with a placement of the IPBO system (SIPBO Construct) was compared to that when the fixation was with an approved Ti-6Al-4V alloy VLP system (SVLP Construct), under a clinically-relevant compressive loading protocol. Performance involved determination of quantitative parameters of the construct (initial longitudinal stiffness (ICLS), final longitudinal stiffness (FCLS), and load-to-failure (P f )) and observation and recording of features of the construct at the fracture point. We also determined the quantitative parameters for the intact synthetic distal radius (control). Results: For each of the quantitative parameters, the range of values for SIPBO Construct was within that for SVLP Construct, suggesting that the IPBO System is a plausible modality. Also, for SIPBO Construct, failure occurred within the polymer zone, whereas, for SVLP Con- 310struct, some failure features were fracture of the cortical wall and of the dorsal proximal fragments. Conclusion: The findings suggest that the IPBO system is plausible. As such, it merits further study; for example, determination of the influence of fracture gap fill ratio (defined as the proportion of the fracture gap that is filled by the expanding balloon as the polymer is injected into the balloon) on a large collection of quantitative biomechanical parameters.

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Section: Testing Methods and Loading Protocolmentioning

confidence: 99%

Biomechanical Comparison of Prototype of a Novel Intramedullary Injectable Bioresorbable Polymer-Bioresorbable Balloon Osteosynthesis and a Volar Locking Plate for Treatment of Distal Radius Fractures

Zysk¹,

Lewis²,

Taxier³

et al. 2017

WJET

View full text Add to dashboard Cite

show abstract

“…The range of compression load used in the present work (10 N -100 N) is within the range of compressive force experienced in the metaphysis of the distal radius during grip tightening exercises performed as part of a rehabilitation regimen following surgical fixation of a DRF [21]. The assigned elastic moduli of the bioresorbable polymers used in the parametric studies of FIXATOR CONSTRUCT Model are within the range of those of bioresorbable polymers either used in an approved dorsal locking plate (Reunite®; Biomet, Inc., Warsaw, IN, USA; co-polymer of poly(l, lactide) (PLLA) and poly (glycolic acid) (PGA) A. Zysk, G. Lewis World Journal of Engineering and Technology [22]), or been proposed for use in plates and screws in DRF plating systems (PLLA) [23], or proposed by the present workers for evaluation of the present fixator system (RESOMER®; Sigma-Aldrich, St. Louis, MO, USA; co-polymer of PLLA and PGA) [24].…”

Section: Discussionmentioning

confidence: 90%

Finite Element Analysis Study of Prototype of a Novel Intramedullary Injectable Bioresorbable Polymer Fixator versus a Volar Plate for Surgical Treatment of Distal Radius Fractures

Zysk¹,

Lewis²

2017

WJET

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Complications and shortcomings of volar plating, which is very widely used for surgical treatment of distal radius fractures, are well known. Thus, there is scope for alternative innovative surgical methods. In the present work, we used the finite element analysis method to compare the biomechanical performance of a model of a construct comprising a simulated distal radius fracture considered fixated using a notional intramedullary injectable bioresorbable polymer-bioresorbable balloon osteosynthesis system ("fixator") versus using a commercially-available volar locking plate (VP). The biomechanical parameters determined were longitudinal stiffness and factor of safety under each of the applied loads. For the fixator model, 1) each of the biomechanical parameters was markedly influenced by fracture gap fill ratio (FGFR) (defined as the proportion of the volume of the fracture gap that is considered occupied by the expanded polymer-filled balloon) but not by modulus of elasticity assigned to the polymer; 2) with FGFR = 100%, stiffness was comparable to that of the Ti-6Al-4V alloy VP construct model; and 3) stiffness was within the range of literature values for stiffness of constructs comprising simulated fractures in fresh cadaveric distal radii fixated using metal volar locking plate. These results suggest that the fixator may be an alternative modality to metal volar plating and, as such, deserves further evaluation.

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“…The watershed line is a border that should not be crossed to avoid flexor tendon problems [10,13,14]. However, in fractures including a palmar lunate facet fragment with short palmar cortex, distal positioning of the palmar plate is needed to stabilize the fragment.…”

Section: Discussionmentioning

confidence: 99%

Involvement of the palmar lunate facet in intra-articular distal radius fractures

Benis

Vanhove

Hollevoet

2020

Orthopaedics & Traumatology: Surgery & Research

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a b s t r a c tBackground: Small fracture fragments of the palmar lunate facet of the distal radius can be difficult to stabilize and may cause loss of reduction and even subluxation of the radiocarpal joint. Material & methods: The aims of the study were to investigate fracture patterns of the intermediate column in 101 intra-articular distal radius fractures with three-dimensional computed tomography, and to determine the prevalence of palmar lunate facet fracture fragments. The size of the fragments was measured to find out how many fragments were small. Results: The palmar lunate facet fragment was present in 61 fractures. Mean length of the palmar cortex measured 13.5 mm (range: 3 to 26.9) and mean area of the lunate facet 115 mm 2 (range: 31 to 267). Seventeen percent of intra-articular distal radius fractures had a palmar lunate facet fragment with a short palmar cortex. Conclusion: With accurate analysis of the preoperative computed tomography scans the typical fracture patterns of the palmar lunate facet are recognisable and adequate fixation technique can be chosen to avoid loss of reduction. Level of evidence: IV.

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Distal radius anatomy applied to the treatment of wrist fractures by plate: a review of recent literature

Cited by 37 publications

References 16 publications

Biomechanical Comparison of Prototype of a Novel Intramedullary Injectable Bioresorbable Polymer-Bioresorbable Balloon Osteosynthesis and a Volar Locking Plate for Treatment of Distal Radius Fractures

Biomechanical Comparison of Prototype of a Novel Intramedullary Injectable Bioresorbable Polymer-Bioresorbable Balloon Osteosynthesis and a Volar Locking Plate for Treatment of Distal Radius Fractures

Finite Element Analysis Study of Prototype of a Novel Intramedullary Injectable Bioresorbable Polymer Fixator versus a Volar Plate for Surgical Treatment of Distal Radius Fractures

Involvement of the palmar lunate facet in intra-articular distal radius fractures

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