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Load Distribution in Dorsally-Angulated Distal Radius Deformity Using Finite Element Analysis
Hirotaka Yan1, Kotaro Sato1, Gaku Takahashi2
1Department of Orthopaedic Surgery, Iwate Medical University, Iwate, Japan.
The Journal of Hand Surgery
|August 16, 2022
Summary
Decreasing the volar tilt of the distal radius shifts load distribution dorsally, reducing stress on volar lunate facet fractures (VLFFs). This finding is crucial for managing carpal injuries.
Area of Science:
- Orthopedic biomechanics
- Skeletal anatomy
- Finite element analysis
Background:
- The volar lunate facet fracture (VLFF) is susceptible to volar-shearing stress due to the carpal load axis positioning.
- Understanding distal radius load distribution is critical for managing VLFFs and preventing carpal displacement.
Purpose of the Study:
- To investigate how varying volar tilt angles of the distal radius affect carpal load distribution.
- To determine if decreasing volar tilt reduces stress on the volar lunate facet.
Main Methods:
- A 3D finite element wrist model was created using CT images.
- Models with volar tilts ranging from 15° to -10° were analyzed.
- Ligaments were simulated as tension-only spring elements.
Main Results:
- Increasing dorsal angulation shifted stress distribution from volar to dorsal and from the lunate to the scaphoid fossa.
- Maximum stress on the volar lunate facet decreased as volar tilt decreased.
- Stress was higher on the lunate fossa for tilts 15° to 5°, and on the scaphoid fossa for tilts ≤0°.
Conclusions:
- Decreasing volar tilt shifts load transmission dorsally and from the lunate to the scaphoid fossa.
- Reduced volar tilt effectively decreases the load on the volar lunate facet fracture.
- This knowledge aids surgeons in treating patients with VLFFs.
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