Archives of Orthopaedic and Trauma Surgery

, Volume 135, Issue 2, pp 201–207 | Cite as

The effect of local bone mineral density on the rate of mechanical failure after surgical treatment of distal radius fractures: a prospective multicentre cohort study including 249 patients

  • Rikli Daniel
  • Goldhahn Joerg
  • Käch Kurt
  • Voigt Christine
  • Platz Andreas
  • Hanson Beate
Trauma Surgery
First Online:
Received:

Abstract

Introduction

The aim of this prospective, multicentre study was to evaluate the influence of local bone mineral density (BMD) on the rate of mechanical failure after locking plate fixation of closed distal radius fractures.

Materials and methods

Between June 2007 and April 2010, 230 women and 19 men with a mean age of 67 years were enrolled. Dual energy X-ray absorptiometry measurements for BMD of the contralateral distal radius were made at 6 weeks post-surgery. Follow-up evaluations at 6 weeks, 3 months and 1 year included wrist mobility and strength as well as standard radiographs. Any local bone/fracture or implant/surgery-related complications were documented. The Disability of the Arm, Shoulder, and Hand (DASH), Patient Rated Wrist Evaluation (PRWE), and EuroQol-5D scores were also recorded at the nominated time points.

Results

Nine patients were reported with mechanical failure at an estimated risk of 3.6 %. The BMD measurements were generally low for the study population with no difference between patients with (0.561 g/cm2) and without (0.626 g/cm2) mechanical failure (p = 0.148). None of the patients achieved their pre-injury functional level and quality of life status after 1 year. 1-year DASH and PRWE scores as well as the difference in maximum grip strength of the affected wrist relative to the contralateral side were significantly higher for patients with mechanical failure (p ≤ 0.036).

Conclusions

Our study could not identify a clear association between bone mineral density status and the risk of mechanical failure. Although the risk for mechanical failure after treatment of distal radius fractures with palmar locking plates is low, these complications must be avoided to prevent negative impact on long-term patient functional and quality of life outcome.

Keywords

Distal radius fracture Radius fracture Complications Mechanical failure Osteoporosis Bone density 
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Notes

Acknowledgments

The authors would like to thank Nicole Steinfelder for valuable help in planning and managing the study, Monica Daigl for statistical analysis, Alexander Joeris for medical input and Melissa Wilhelmini and Andrea Sebald for copy-editing of this manuscript (all AO Clinical Investigation and Documentation). The authors on this paper are all: Research Partners of the Clinical Priority Program “Fracture fixation in osteoporotic bone FFOB” of AOTrauma Davos, Switzerland. The presented clinical investigation was performed with the support of the AO Foundation Network.

Conflict of interest

None.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Rikli Daniel
    • 1
  • Goldhahn Joerg
    • 2
  • Käch Kurt
    • 3
  • Voigt Christine
    • 4
  • Platz Andreas
    • 5
  • Hanson Beate
    • 6
  1. 1.Department of TraumatologyUniversity Hospital BaselBaselSwitzerland
  2. 2.Institute for BiomechanicsETH ZurichZurichSwitzerland
  3. 3.Department of Trauma SurgeryKantonsspital WinterthurWinterthurSwitzerland
  4. 4.Department of Trauma and Reconstructive SurgeryFriederikenstift HannoverHannoverGermany
  5. 5.Department of General, Hand, and Trauma SurgeryStadtspital TriemliZurichSwitzerland
  6. 6.AO Clinical Investigation and DocumentationAO FoundationDübendorfSwitzerland

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