Abstract
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.
Highlights
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)
1) each of the biomechanical parameters was markedly influenced by fracture gap fill ratio (FGFR) 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
Distal radius fractures (DRFs) are a common occurrence, by some reports accounting for ∼17% of all fractures and ∼8% of all bony injuries presented in emergency rooms/departments [1] [2]
Summary
Distal radius fractures (DRFs) are a common occurrence, by some reports accounting for ∼17% of all fractures and ∼8% of all bony injuries presented in emergency rooms/departments [1] [2]. There is a very large and diverse assortment of treatment/management modalities for these fractures. For a given fracture type, there is lack of consensus on the optimal treatment modality [4] [6] [7] [8] [9]. For certain types, the volar locking plate is very widely used [6] [7] [8]. There is scope for development of a new generation of innovative modalities as an alternative to the volar locking plate system
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