The metaphyseal bone defect in distal radius fractures and its implication on trabecular remodeling—a histomorphometric study (case series)

Journal of Orthopaedic Surgery and Research

Thomas Klestil²  Michael Schuetz⁴  Michael Rieger¹  Ingrid Sitte³  Roland Steck⁴  Martin Lutz² 

[1] Department for Radiology General Hospital Hall in Tirol, Milser Strasse 10, Hall in Tirol, 6060, Austria;Department for Trauma Surgery, LK Baden Mödling, Sr. M. Restituta Gasse 12, Mödling, 2340, Austria;Department for Trauma Surgery, Medical University Innsbruck, Anichstrasse 35, Innsbruck, 6020, Austria;Institute of Health and Biomedical Innovation, Queensland University of Technology Brisbane, 60 Musk Avenue, Kelvin Grove QLD, Brisbane, 4059, Australia

关键词: Histomorphometry;    Trabecular ultrastructure;    Bone void;    Distal radius fracture;   

Others  :  1180748
DOI  :  10.1186/s13018-015-0205-9

 received in 2014-11-26, accepted in 2015-03-29,  发布年份 2015

【 摘 要 】

Background

The invention of the locking plate technology leads to alterations of treatment strategies at metaphyseal fracture sites with the concept of spontaneous remodeling of trabecular bone voids. Whereas trabecular regeneration has been proven in experimental animal studies, no histologic data exist on human fracture healing with special emphasis on bone voids.

Methods

In order to qualify the trabecular bone remodeling capacity in vivo, bone specimens from the metaphyseal bone void were analyzed 14 months after trauma using quantitative histomorphometry. Twenty-five patients with an unstable dorsally displaced distal radius fracture were fixed with a palmar locking plate without additional bone graft or substitute. At implant removal, specimens from the previous compression void were harvested with a trephine in a volar-dorsal direction. In 16 patients, histomorphometric analysis could be performed, comparing the dorsal trabecular network with the volar, non-compressed ultrastructure.

Results

Significant differences for bone volume/total volume (BV/TV), trabecular number (TbN) and trabecular separation (TbSp), but not for trabecular thickness (TbTh) and osteoid volume/total volume (OV/TV), were detected. Neither patient age, defect size nor gender had a significant influence on bone remodeling.

Conclusions

The results of this study indicate that trabecular bone remodeling does not lead to pre-trauma bone quality in metaphyseal bone compression voids following reduction and application of a locking plate.

【 授权许可】

   
2015 Lutz et al.; licensee BioMed Central.

【 图 表 】

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