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器官移植长期效应期刊
SJR: 0.145 SNIP: 0.491 CiteScore™: 0.89

ISSN 打印: 1050-6934
ISSN 在线: 1940-4379

器官移植长期效应期刊

DOI: 10.1615/JLongTermEffMedImplants.2020035806
pages 131-134

Biomechanical Comparison between Volar Plate Fixator and Nonbridge External Wrist Fixator

M. A. Hajianpour
Total Orthopaedic Care, Lauderdale Lakes, FL 33313
T. Sano
NIPRO Medical Corporation, Bridgewater, NJ
E. A. Ouellette
Miami Orthopedics & Sports Medicine Group, Baptist Health of South Florida, Coral Gables, FL
Edward L. Milne
Max Biedermann Institute for Biomechanics at Mount Sinai, Miami Beach, FL
David N. Kaimrajh
Max Biedermann Institute for Biomechanics at Mount Sinai, Miami Beach, FL
Loren L. Latta
Max Biedermann Institute for Biomechanics, Mount Sinai Medical Center, Miami Beach, FL; Department of Mechanical Engineering, University of Miami, Coral Gables, FL; Department of Orthopaedics, University of Miami, Miller School of Medicine, Miami, FL 33136

ABSTRACT

Intra-articular distal radius fractures are difficult to reduce and maintain by nonoperative means. ORIF leaves implants in the patient long after the fracture is healed. External fixation can stabilize the reduced fracture and leaves no long-term implants. The nonbridging fixator (NBX) will provide better reduction and comparable rigidity of fixation to a volar plate for a 5-fragment, OTA 23 C3.2 distal radius fracture. A 5-part distal radius fracture was created in 5 pairs of cadaver arms. One arm was randomly fixed with the NBX fixator; the matched pair was fixed with a volar plate (VPS). Fluoroscopic images recorded the extremes of passive volar-dorsiflexion range of motion (ROM) and radial-ulnar deviation ROM. Each arm was loaded with an axial force at a constant displacement rate until failure. The average reduction of radial tilt achieved for the NBX group was 13.8 ± 4.8° and 6.3 ± 4.7° for VPS; radial length: 3.4 ± 3.7 mm for NBX and 1.9 ± 1.0 mm for VPS; volar tilt: 26.3 ± 12.4° for NBX and 14.0 ± 13.5° for VPS. For NBX, ROM was slightly less after fixation than before fracture. ROM with volar plating was greater after fracture. The peak axial load for NBX was 925 ± 445 N; for VPS, 2,152 ± 1023 N. NBX had minimal effect on ROM and provided adequate strength and restoration of alignment at least as good as VPS for this 5-part fracture model.

REFERENCES

  1. Jupiter JB, Fernandez DL, Toh CL, Fellman T, Ring D. Operative treatment of volar intra-articular fractures of the distal end of the radius. J Bone Joint Surg Am. 1996;78(12):1817-28. PMID: 8986658. .

  2. Grewal R, Perey B, Wilmink M, Stothers K. A randomized prospective study on the treatment of intra-articular distal radius fractures: Open reduction and internal fixation with dorsal plating versus mini open reduction, percutaneous fixation, and external fixation. J Hand Surg. 2005;30(4):764-72. .

  3. Atroshi I, Brogren E, Larsson GU, Kloow J, Hofer M, Berggren AM. Wrist-bridging versus nonbridging external fixation for displaced distal radius fractures. Acta Orthopaed. 2006;7(3):445-53. .

  4. Slutsky DJ. Nonbridging external fixation of intra-articular distal radius fractures. Hand Clin. 2005;21:381-94. .


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