Association of Secondary Displacement of Distal Radius Fractures with Cortical Bone Quality at the Distal Radius

Overview

Journal Arch Orthop Trauma Surg

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2020 Oct 31

PMID 33128608

Citations 5

Authors

A M Daniels

H M J Janzing

C E Wyers

B van Rietbergen

L Vranken

R Y van der Velde

P P M M Geusens

S Kaarsemaker

M Poeze

J P van den Bergh

Affiliations

Soon will be listed here.

Abstract

Introduction: The aim of this study was to investigate the associations of patient characteristics, bone mineral density (BMD), bone microarchitecture and calculated bone strength with secondary displacement of a DRF based on radiographic alignment parameters.

Materials And Methods: Dorsal angulation, radial inclination and ulnar variance were assessed on conventional radiographs of a cohort of 251 patients, 38 men and 213 women, to determine the anatomic position of the DRF at presentation (primary position) and during follow-up. Secondary fracture displacement was assessed in the non-operatively treated patients (N = 154) with an acceptable position, preceded (N = 97) or not preceded (N = 57) by primary reduction (baseline position). Additionally, bone microarchitecture and calculated bone strength at the contralateral distal radius and tibia were assessed by HR-pQCT in a subset of, respectively, 63 and 71 patients.

Outcome: Characteristics of patients with and without secondary fracture displacement did not differ. In the model with adjustment for primary reduction [OR 22.00 (2.27-212.86), p = 0.008], total [OR 0.16 (95% CI 0.04-0.68), p = 0.013] and cortical [OR 0.19 (95% CI 0.05-0.80], p = 0.024] volumetric BMD (vBMD) and cortical thickness [OR 0.13 (95% CI 0.02-0.74), p = 0.021] at the distal radius were associated with secondary DRF displacement. No associations were found for other patient characteristics, such as age gender, BMD or prevalent vertebral fractures.

Conclusions: In conclusion, our study indicates that besides primary reduction, cortical bone quality may be important for the risk of secondary displacement of DRFs.

Citing Articles

The Volar Cortical Hinge: An Independent Risk Factor for Distal Radius Fracture Displacement.

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A novel pulsed electromagnetic field device as an adjunct therapy to surgical treatment of distal radius fractures: a prospective, double-blind, sham-controlled, randomized pilot study.

Factor S, Druckmann I, Kazum E, Atlan F, Tordjman D, Rosenblatt Y Arch Orthop Trauma Surg. 2023; 144(1):543-550.

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Minimally Invasive Fixation with Dorsal Suspension Button and Volar Plate in Distal Radius Fractures with Dorsal Die Punch Fragments: A Preliminary Study.

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Benedikt S, Horling L, Stock K, Degenhart G, Pallua J, Schmidle G Quant Imaging Med Surg. 2023; 13(3):1336-1349.

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Cortical bone thickness of the distal radius predicts the local bone mineral density.

Schmidutz F, Schopf C, Yan S, Ahrend M, Ihle C, Sprecher C Bone Joint Res. 2021; 10(12):820-829.

PMID: 34927444 PMC: 8696524. DOI: 10.1302/2046-3758.1012.BJR-2020-0271.R1.

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