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Subchondral placement of distal radius locking plate has insignificant impact on articular contact pressures
Walker MH. J Hand Surg. 2011. doi:10.1016/j.jhsa.2011.05.015
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Articular contact pressures do not appear to be significantly changed through the use of distal radius locking plates with subchondral hardware placement, according to a study from researchers in Maryland.
Researchers placed 12 cadaveric forearms into an axial loading protocol using an intra-articular force sensor to measure peak contact pressure, total pressure and contact area within the distal radius. The researchers also internally validated sensor placement, as well as reproducibility. The cadaveric forearms were tested prior to fixation (control group), following the application of a palmar distal radius locking plate and finally following the simulation of a metaphyseal fracture.
The researchers reported they were unable to determine any significant differences in maximum pressure, total pressure or contact area among the three groups. They did note, however, that the control group and both plated groups demonstrated significant differences in contact footprint.
“Although locking screws placed in subchondral bone of the distal radius for fracture fixation may alter the stress distribution across the radiocarpal joint, we found no evidence that peak stresses across the joint were changed,” the authors wrote. “Therefore, it seems unlikely that periarticular locking screws contribute to long-term arthrosis after fixation of extra-articular distal radius fractures.”