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Journal of Hand Surgery (British and European Volume)
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Articles

Malunited Colles’ Fracture

Analysis of stress distribution

T. MIYAKE
H. HASHIZUME
H. INOUE
Q. SHI
N. NAGAYAMA

From the Department of Orthopaedic Surgery, Okayama University Medical School, and from the Industrial Technology Center of Okayama Prefecture, Okayama, Japan

Correspondence: H. Hashizume, Department of Orthopedic Surgery, Okayama University Medical School, 2-5-1 Shikata-cho, Okayama, Japan 700.

To try to explain disability in the wrist after malunited Colles’ fractures, an experiment was designed to evaluate pressure distribution through the wrist joint with varying degrees of angulation of the distal radius. The results of computer simulation analysis of stress concentration using finite element methods were compared with those of pressure distribution studies on the radial articular surface of cadaveric radii in various positions using pressure-sensitive film. Stress existed in volar regions of the radio-lunate joint under normal pressure in the neutral position, but shifted to dorsal regions of the joint, and was concentrated when dorsal angulation reached 30°. We believe that concentrated loads result in pain and may lead to early degenerative joint disease. Early additional reduction of a displaced fragment or a post-fusion osteotomy should be considered when dorsal angulation exceeds 30° in malunited distal radial fractures to decrease abnormal loading across the wrist joint.

Journal of Hand Surgery (British and European Volume), Vol. 19, No. 6, 737-742 (1994)
DOI: 10.1016/0266-7681(94)90248-8
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