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Raducha JE, Hresko A, Molino J, et al. Weight-Bearing Restrictions With Distal Radius Wrist-Spanning Dorsal Bridge Plates. J Hand Surg Am. 2021;doi: 10.1016/j.jhsa.2021.04.008.
Raducha, J. E., Hresko, A., Molino, J., Got, C. J., Katarincic, J., & Gil, J. A. (2021). Weight-Bearing Restrictions With Distal Radius Wrist-Spanning Dorsal Bridge Plates. The Journal of hand surgery, . https://doi.org/10.1016/j.jhsa.2021.04.008
Raducha, Jeremy E, et al. "Weight-Bearing Restrictions With Distal Radius Wrist-Spanning Dorsal Bridge Plates." The Journal of hand surgery vol. (2021). doi: https://doi.org/10.1016/j.jhsa.2021.04.008
Raducha JE, Hresko A, Molino J, Got CJ, Katarincic J, Gil JA. Weight-Bearing Restrictions With Distal Radius Wrist-Spanning Dorsal Bridge Plates. J Hand Surg Am. 2021 May 19; doi: 10.1016/j.jhsa.2021.04.008. Epub 2021 May 19. PMID: 34023193.
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J Hand Surg Am. 2021 May 19; doi: 10.1016/j.jhsa.2021.04.008. Epub 2021 May 19.

Weight-Bearing Restrictions With Distal Radius Wrist-Spanning Dorsal Bridge Plates.

The Journal of hand surgery

Jeremy E Raducha, Andrew Hresko, Janine Molino, Christopher J Got, Julia Katarincic, Joseph A Gil

Affiliations

  1. Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI. Electronic address: [email protected].
  2. University Orthopedics Incorporated, Providence, RI.
  3. Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI.
  4. Department of Orthopaedics, Warren Alpert Medical School of Brown University, Providence, RI; University Orthopedics Incorporated, Providence, RI.

PMID: 34023193 DOI: 10.1016/j.jhsa.2021.04.008

Abstract

PURPOSE: The fixation of comminuted distal radius fractures using wrist-spanning dorsal bridge plates has been shown to have good postoperative results. We hypothesized that using a stiffer bridge plate construct results in less fracture deformation with loads required for immediate crutch weight bearing.

METHODS: We created a comminuted, extra-articular fracture in 7 cadaveric radii, which were fixed using dorsal bridge plates. The specimens were positioned to simulate crutch/walker weight bearing and axially loaded to failure. The axial load and mode of failure were measured using 2- and 5-mm osteotomy deformations as cutoffs. Bearing 50% and 22% of the body weight was representative of the force transmitted through crutch and walker weight bearing, respectively.

RESULTS: The load to failure at 2-mm deformation was greater than 22% body weight for 2 of 7 specimens and greater than 50% for 1 of 7 specimens. The load to failure at 5-mm deformation was greater than 22% body weight for 6 of 7 specimens and greater than 50% for 4 of 7 specimens. The mean load to failure at 2-mm gap deformation was significantly lower than 50% body weight (110.4 N vs 339.2 N). The mean load to failure at 5-mm deformation was significantly greater than 22% body weight (351.8 N vs 149.2 N). All constructs ultimately failed through plate bending.

CONCLUSIONS: All constructs failed by plate bending at forces not significantly greater than the 50% body weight force required for full crutch weight bearing. The bridge plates supported forces significantly greater than the 22% body weight required for walker weight bearing 6 of 7 times when 5 mm of deformation was used as the failure cutoff.

CLINICAL RELEVANCE: Elderly, walker-dependent patients may be able to use their walker as tolerated immediately after dorsal bridge plate fixation for extra-articular fractures. However, patients should not be allowed to bear full weight using crutches immediately after bridge plating.

Copyright © 2021 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Keywords: Bridge plating; distal radius; immediate weight bearing

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