A finite element model to assess distal radius fracture stability

This research provides an analysis of some major factors thought to influence extra-articular distal radius fracture stability: site and severity of comminution, soft tissue injury, bone quality, and quality of reduction. A finite element model of the distal radius, distal ulna, scaphoid, lunate and associated soft tissues was constructed from CT scans and validated experimentally. Using the validated finite element model, the independent and synergistic effects of each variable on clinical parameters was used to determine distal radius fracture stability. These parameters included volar tilt, radial inclination, and radial shortening. Results illustrated that site and severity of comminution had the greatest influence on the clinical parameters. The model predicted that moderate-to-severe dorsal comminution may result in severe distal radius fracture instability. The addition of soft tissue injury, reduced bone quality, and the presence of an imperfect reduction compounded the likelihood of instability.