Mathematical modelling for the comparison of plate and intramedullary osteosynthesis stability in intraarticular distal radius fractures

Abstract

A comparison between plate and intramedullary osteosynthesis techniques in terms of the biomechanical stability of distal radius fracture fixation. Mathematical modelling was used to simulate distal radius fractures, type C1 and type C2, and to compare the stability of osteosynthesis in both techniques under several wrist joint load conditions: axial compressive loading of the radius, bending loads in volar and dorsal flexion and radial and ulnar deviation, and axial torsional loading of the forearm. For both type C1 and type C2 fractures, the stability of intramedullary osteosynthesis was comparable with plate osteosynthesis in dorsal flexion. Plate osteosynthesis proved to be more stable only in ulnar deviation. The intramedullary X-screw technique provided more stability when loads were applied in volar flexion, radial deviation, pronation and supination, and in axial loading of the radius. The result of mathematical simulations was comparable for both types of fracture. It showed a higher stability of intramedullary osteosynthesis. Although when lower force intensity was applied, both techniques were comparable (Fig. 8, Ref. 16).