Assessment of inducible fracture micromotion in distal radial fractures using radiostereometry

Martin R. Downing, P. Blair-Ashcroft, Alan J. Johnstone, Olaf Bach, Suzi Mackenzie, G. Patrick Ashcroft

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives: This Study examined the potential for measuring dynamic inducible micromotion (DIMM) between fragments in healing distal radial fractures using radiostereometry (RSA).

Design: Prospective imaging Study.

Setting: University teaching hospital.

Patients: Nine patients with low-impact distal radial fractures.

Intervention: Volar locked plating of the fracture with insertion of tantalum beads into bone fragments. RSA examinations at 1 day and then 2, 6, 26, and 52 weeks. Motion at the fracture site was induced by maximal voluntary hand grip using a Jamar dynamometer. Radiographs were analyzed using locally developed and UMRSA software.

Main Outcome Measurements: DIMM and migration were calculated as translations and rotation of the main distal segment. Clinical precision was assessed under repeatability conditions.

Results: Precision (as 95% error limit) ranged from 0.06 to 0.13 mm and 0.5 to 0.8 degrees for migration, and from 0.10 to 0.14 mm and 0.6 to 1.0 degrees for DIMM. DIMM was characterized by axial and dorsal compression with dorsiflexion. The median DIMM of patients reached a maximum at 2 weeks: mainly as 0.3 mm axial compression, 0.3 mm dorsal compression, and 2.5 degrees dorsiflexion. DIMM ceased by 26 weeks, indicating union of all fractures. Fracture collapse continued until the 26-week measurement, ranging between 0.2 and 2.8 mm axially. Instability of some intraosseous markers was observed.

Conclusions: The precision of this RSA method was sufficient to observe inducible movements occurring during fracture healing. This has the potential for quantifying rates of fracture union and improving understanding of the available treatments.

Original languageEnglish
Pages (from-to)S96-105
Number of pages10
JournalJournal of Orthopaedic Trauma
Volume22
Issue numberSuppl. 8
DOIs
Publication statusPublished - Sep 2008

Keywords

  • radiostereometry
  • induced micromotion
  • in vivo precision
  • radial fracture
  • volar fixation
  • roentgen stereophotogrammetric analysis
  • dorsally displaced fractures
  • tibial components
  • plate fixation
  • locked plates
  • patient
  • accuracy
  • motion
  • system
  • model

Cite this

Assessment of inducible fracture micromotion in distal radial fractures using radiostereometry. / Downing, Martin R.; Blair-Ashcroft, P.; Johnstone, Alan J.; Bach, Olaf; Mackenzie, Suzi; Ashcroft, G. Patrick.

In: Journal of Orthopaedic Trauma, Vol. 22, No. Suppl. 8, 09.2008, p. S96-105.

Research output: Contribution to journalArticle

Downing, Martin R. ; Blair-Ashcroft, P. ; Johnstone, Alan J. ; Bach, Olaf ; Mackenzie, Suzi ; Ashcroft, G. Patrick. / Assessment of inducible fracture micromotion in distal radial fractures using radiostereometry. In: Journal of Orthopaedic Trauma. 2008 ; Vol. 22, No. Suppl. 8. pp. S96-105.
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abstract = "Objectives: This Study examined the potential for measuring dynamic inducible micromotion (DIMM) between fragments in healing distal radial fractures using radiostereometry (RSA).Design: Prospective imaging Study.Setting: University teaching hospital.Patients: Nine patients with low-impact distal radial fractures.Intervention: Volar locked plating of the fracture with insertion of tantalum beads into bone fragments. RSA examinations at 1 day and then 2, 6, 26, and 52 weeks. Motion at the fracture site was induced by maximal voluntary hand grip using a Jamar dynamometer. Radiographs were analyzed using locally developed and UMRSA software.Main Outcome Measurements: DIMM and migration were calculated as translations and rotation of the main distal segment. Clinical precision was assessed under repeatability conditions.Results: Precision (as 95{\%} error limit) ranged from 0.06 to 0.13 mm and 0.5 to 0.8 degrees for migration, and from 0.10 to 0.14 mm and 0.6 to 1.0 degrees for DIMM. DIMM was characterized by axial and dorsal compression with dorsiflexion. The median DIMM of patients reached a maximum at 2 weeks: mainly as 0.3 mm axial compression, 0.3 mm dorsal compression, and 2.5 degrees dorsiflexion. DIMM ceased by 26 weeks, indicating union of all fractures. Fracture collapse continued until the 26-week measurement, ranging between 0.2 and 2.8 mm axially. Instability of some intraosseous markers was observed.Conclusions: The precision of this RSA method was sufficient to observe inducible movements occurring during fracture healing. This has the potential for quantifying rates of fracture union and improving understanding of the available treatments.",
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T1 - Assessment of inducible fracture micromotion in distal radial fractures using radiostereometry

AU - Downing, Martin R.

AU - Blair-Ashcroft, P.

AU - Johnstone, Alan J.

AU - Bach, Olaf

AU - Mackenzie, Suzi

AU - Ashcroft, G. Patrick

PY - 2008/9

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N2 - Objectives: This Study examined the potential for measuring dynamic inducible micromotion (DIMM) between fragments in healing distal radial fractures using radiostereometry (RSA).Design: Prospective imaging Study.Setting: University teaching hospital.Patients: Nine patients with low-impact distal radial fractures.Intervention: Volar locked plating of the fracture with insertion of tantalum beads into bone fragments. RSA examinations at 1 day and then 2, 6, 26, and 52 weeks. Motion at the fracture site was induced by maximal voluntary hand grip using a Jamar dynamometer. Radiographs were analyzed using locally developed and UMRSA software.Main Outcome Measurements: DIMM and migration were calculated as translations and rotation of the main distal segment. Clinical precision was assessed under repeatability conditions.Results: Precision (as 95% error limit) ranged from 0.06 to 0.13 mm and 0.5 to 0.8 degrees for migration, and from 0.10 to 0.14 mm and 0.6 to 1.0 degrees for DIMM. DIMM was characterized by axial and dorsal compression with dorsiflexion. The median DIMM of patients reached a maximum at 2 weeks: mainly as 0.3 mm axial compression, 0.3 mm dorsal compression, and 2.5 degrees dorsiflexion. DIMM ceased by 26 weeks, indicating union of all fractures. Fracture collapse continued until the 26-week measurement, ranging between 0.2 and 2.8 mm axially. Instability of some intraosseous markers was observed.Conclusions: The precision of this RSA method was sufficient to observe inducible movements occurring during fracture healing. This has the potential for quantifying rates of fracture union and improving understanding of the available treatments.

AB - Objectives: This Study examined the potential for measuring dynamic inducible micromotion (DIMM) between fragments in healing distal radial fractures using radiostereometry (RSA).Design: Prospective imaging Study.Setting: University teaching hospital.Patients: Nine patients with low-impact distal radial fractures.Intervention: Volar locked plating of the fracture with insertion of tantalum beads into bone fragments. RSA examinations at 1 day and then 2, 6, 26, and 52 weeks. Motion at the fracture site was induced by maximal voluntary hand grip using a Jamar dynamometer. Radiographs were analyzed using locally developed and UMRSA software.Main Outcome Measurements: DIMM and migration were calculated as translations and rotation of the main distal segment. Clinical precision was assessed under repeatability conditions.Results: Precision (as 95% error limit) ranged from 0.06 to 0.13 mm and 0.5 to 0.8 degrees for migration, and from 0.10 to 0.14 mm and 0.6 to 1.0 degrees for DIMM. DIMM was characterized by axial and dorsal compression with dorsiflexion. The median DIMM of patients reached a maximum at 2 weeks: mainly as 0.3 mm axial compression, 0.3 mm dorsal compression, and 2.5 degrees dorsiflexion. DIMM ceased by 26 weeks, indicating union of all fractures. Fracture collapse continued until the 26-week measurement, ranging between 0.2 and 2.8 mm axially. Instability of some intraosseous markers was observed.Conclusions: The precision of this RSA method was sufficient to observe inducible movements occurring during fracture healing. This has the potential for quantifying rates of fracture union and improving understanding of the available treatments.

KW - radiostereometry

KW - induced micromotion

KW - in vivo precision

KW - radial fracture

KW - volar fixation

KW - roentgen stereophotogrammetric analysis

KW - dorsally displaced fractures

KW - tibial components

KW - plate fixation

KW - locked plates

KW - patient

KW - accuracy

KW - motion

KW - system

KW - model

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DO - 10.1097/BOT.0b013e3181839669

M3 - Article

VL - 22

SP - S96-105

JO - Journal of Orthopaedic Trauma

JF - Journal of Orthopaedic Trauma

SN - 0890-5339

IS - Suppl. 8

ER -