Journal
JOURNAL OF HAND SURGERY-AMERICAN VOLUME
Volume 27A, Issue 2, Pages 223-232Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/jhsu.2002.32083
Keywords
distal radius fracture; carpal instability; wrist trauma
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A cadaver model was used in a biomechanical study of dorsally angulated distal radius fractures to evaluate alterations in carpal kinematics. Distal radius fractures were simulated by dorsal closing-wedge osteotomy and fixed with a custom-designed external fixator. A magnetic tracking device measured the carpal bone motions in several positions of dorsal angulation from neutral tilt to 300 dorsal tilt. Changes in carpal alignment showed different patterns between each specimen consisting of a spectrum from dorsal subluxation of the entire carpus to adaptive dorsal carpal instability (DISI deformity). Components of carpal bone motion were altered markedly at all positions of dorsal angulation of the distal radius. The severity of the DISI deformity and related carpal instability correlated well with the alterations of carpal kinematics during wrist flexion and extension, whereas dorsal subluxation alone had a poor relationship with changes in carpal kinematics. The amount of DISI deformity and the degree of dorsal angulation of the radius may be prognostic factors when considering whether to perform a corrective osteotomy of the distal radius. Copyright (C) 2002 by the American Society for Surgery of the Hand.
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