gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Forearm diaphyseal bone strength recovers three months after plate removal

Meeting Abstract

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  • presenting/speaker Yusuke Matsuura - Chiba University, Chiba, Japan
  • Tomoyuki Rokkaku - Chiba Municipal Hospital, Chiba, Japan
  • Kazuki Kuniyoshi - Nagareyama Central Hospital, Nagareyama, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-929

doi: 10.3205/19ifssh1304, urn:nbn:de:0183-19ifssh13048

Published: February 6, 2020

© 2020 Matsuura et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Forearm diaphysis fractures are usually treated by open reduction internal fixation with plates. Long after surgery, some patients present with bone atrophy adjacent to the plate, occasionally leading to refracture. Because we have an incomplete understanding of when bone strength recovers, the aim of this study was to investigate changes in forearm bone strength after plate removal using a computed tomography (CT) based, specimen-specific finite element model (FEM).

Methods: We included 13 forearm fractures from 7 patients treated with locking plates. CT imaging of both forearms was performed before plate removal, and at 1, 3, and 6 months after plate removal to assess local bone mineral density and predict bone strength. We created a 3-dimensional FEM with Mechanical Finder software, using a previously-reported CT data.

Results and Conclusions: Mean patient age at plate remove was 33.5 years. The mean period of plate fixation was 33.2 months. The mean bone strength of the healthy contralateral side was 7910.2N. The mean strengths of the injured side before plate removal, and 1, 3, and 5 months after plate remove were 4093.1N, 4178.3, 6139.7, and 7220.7N, respectively. The injury-healthy ratios were 49.0% (baseline), 62.7% (1 month), 88.0% (3 months), and 95.2% (5/6 months). Compared with the healthy side, bone strength was significantly decreased after removal. By 3 months after plate removal, bone strength was significantly recovered.

In conclusion, bone strength decreases after plate fixation, often recovering by 3 months after plate removal. It may be necessary for patients to restrict potentially injurious activities for approximately 3 months or until bone strength recovers.