Scientific articleEvaluation of Bone Atrophy After Treatment of Forearm Fracture Using Nonlinear Finite Element Analysis: A Comparative Study of Locking Plates and Conventional Plates
Section snippets
Subjects
This study enrolled 21 patients who had undergone open reduction internal fixation with plates that remained in place after treatment of forearm (ulna and/or radius) fractures between January 1999 and December 2007, at 1 of the 3 hospitals. The regional medical ethics committees of each hospital approved the study. Only patients who consented and remained in contact with study coordinators for 5 years or more were included in the final analysis. AO classification, joint range of motion (ROM),
Long-term clinical results after forearm fracture
Of the 21 subjects enrolled, 15 patients were observed for the minimum period required for the project (Table 1). Of these, mean age at surgery was 48.0 years (range, 19–66 years). Eight patients were treated with locking plates (3 men and 5 women) whereas 7 were treated with conventional plates (4 men and 3 women). All locking plates were the Limited Contact–Locking Compression Plate (Synthes, Davos, Switzerland). Conventional plates used for treatment included the Limited Contact–Locking
Discussion
Through a number of assessment parameters, the current study demonstrated that open reduction of forearm fractures with locking plates resulted in more bone atrophy in long-term follow-up, compared with that after using conventional plates. In addition, one of these assessments was a novel computational prediction of bone strength that can be used to determine resistance to refracture after plate removal.
Previous biomechanical studies demonstrated the advantages of stabilization using locking
Acknowledgments
The authors thank Makoto Otsuka, PhD, Masatsune Yamagata, PhD, Masaya Mimura, PhD, and Tadashi Tanaka, PhD for assistance with data collection.
References (17)
- et al.
Plate osteosynthesis of diaphyseal fractures of the radius and ulna
Injury
(1996) - et al.
Bone mineral density after removal of rigid plates from forearm fractures: preliminary report
J Orthop Sci
(2003) - et al.
Bone strength: the whole is greater than the sum of its parts
Semin Arthritis Rheum
(2006) Improved prediction of proximal femoral fracture load using nonlinear finite element models
Med Eng Phys
(2001)- et al.
Prediction of bone mechanical properties using QUS and pQCT: study of the human distal radius
Med Eng Phys
(2008) - et al.
Early temporary porosis of bone induced by internal fixation implant: a reaction to necrosis, not to stress protection?
Clin Orthop Relat Res
(1988) - et al.
Locking compression plate in the treatment of forearm fractures: a prospective study
J Orthop Surg (Hong Kong)
(2006) - et al.
Problems of bridging plate fixation for the treatment of forearm shaft fractures with the locking compression plate
Arch Orthop Trauma Surg
(2011)
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2022, Journal of Hand Surgery Global OnlineCitation Excerpt :Surgical fixation of fractures may lead to local bone atrophy by impairing blood flow, as seen in animal models.34,35 Stress shielding and impaired periosteal circulation also drive local bone loss, as confirmed in diaphyseal forearm fractures treated with ORIF.36,37 However, bone loss in the hand after DRF treated with volar plates has not been widely reported.
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