BoneKEy Reports | BoneKEy Watch
Measuring movement within radial fractures treated with Volar plating
DOI:10.1038/bonekey.2012.86
Madanat et al. performed radiostereometric analysis (RSA) in 15 patients whose intra-articular radial fracture was held in place to heal using a Volar plate. Volar plating has become a popular technique for treating this type of fracture but it has not been subjected to clinical trials because validated methods to assess its success quantitatively do not exist.
The study demonstrated that the use of RSA, which involved placing tantalum RSA markers at various points using a spring-loaded piston, has the potential to be able to measure the progress of fracture union after Volar plating. It is, however, a challenging technique that requires around 13 markers, placed proximally and distally, some before and some after fixing the plate.
The results also provided an insight into the bone healing process. Up to two weeks after surgery, permanent and significant translation and rotation occurred at the fracture site. Subsequently, from weeks 6 to 18, additional inducible interfragmentary micromotion was observed when patients attempted maximal grip.
Editor's comment: This study shows that micromotion occurs in radial fractures up to 18 weeks, and that permanent deformations occur even after internal fixation. The significance of these observations will require further study and the RSA technique could be of utility in randomized trials of bone healing.
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