Forces in the Distal Radius During a Pushup or Active Wrist Motions.

Abstract

To determine the 6 degrees of freedom forces and moments in the distal radius that occur during a pushup or other active wrist motions. Eight fresh-frozen cadaveric wrists were moved through 6 physiological motions and held at 1 static pushup position while the force through the distal radius was measured with a 6 degrees of freedom load cell. Three levels of compressive force were applied at the pushup position. Active wrist motions caused axial forces up to 283 N and moments up to 0.7 N-m. Those motions with a smaller range had significantly smaller axial forces than the larger flexion-extension or dart-thrower's motions. With an 89-N pushup force applied, the average maximum axial force was 69 N, the radially directed force was 12 N, and the moment about the radioulnar axis was 2.3 N-m. Linear extrapolation of the forces to 100% body weight indicate that the axial force going through the distal radius would be 663 N, the radial force would be 147 N, and the moment about the radioulnar axis would be 18.6 N-m. Large distal radius forces and moments can occur during pushup and active wrist motions. There are not only large axial compressive forces but also nontrivial radially directed forces. This study may help surgeons and therapists better treat complicated distal radius fractures as well as provide for better comparisons of existing or new distal radius plates and constructs that are designed to treat these complicated loading patterns.