Department of Orthopaedic Sports Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany.
Department of Orthopaedic and Trauma Surgery, Helios Hospital Munich West, Steinerweg 5, 81241, Munich, Germany.
BMC Musculoskelet Disord. 2019 Apr 6;20(1):147. doi: 10.1186/s12891-019-2529-9.
The most common location for articular fractures of the radial head is often reported to be the anterior lateral aspect of the radial head with the arm in neutral position. However, these findings mainly base on clinical observations rather than precise biomechanical measurements. The purpose of this study was to evaluate the formation of proximal radius fractures, the association between axial forces and fracture morphology, energy to failure and bone stiffness in a biomechanical in-vitro setup.
18 fresh-frozen cadaveric radii performed axial load compression with 10 mm/min loading until bone failure. Energy to failure and bone stiffness were recorded. Proximal radial head fracture morphology and affection of the anterolateral quadrant were optically analyzed.
All radii survived a compression load of 500 N. The mean compressive forces that lead to failure were 2,56 kN (range 1,30 - 7,32). The mean stiffness was 3,5 kN/mm (range 2,0 - 4,9). 11 radial neck fractures and 7 radial neck and radial head multifragment fractures were documented. The anterolateral quadrant was involved in 78% of tested radii.
The anterolateral quadrant of the radial head (in neutral position of the forearm) is confirmed to be the most common location for articular radial head fractures in a biomechanical setting. In case of a fall on the outstretched arm radial neck fractures should be securely ruled out due to prior occurrence to radial neck and head fractures.
桡骨头关节骨折最常见的部位通常被报道为桡骨头前外侧，手臂处于中立位。然而，这些发现主要基于临床观察，而不是精确的生物力学测量。本研究的目的是在生物力学体外设置中评估近端桡骨骨折的形成、轴向力与骨折形态之间的关系、失效能和骨刚度。
18 个新鲜冷冻尸体桡骨以 10mm/min 的加载速度进行轴向压缩加载，直至骨失效。记录失效能和骨刚度。通过光学分析，对近端桡骨头骨折形态和前外侧象限的受累情况进行分析。
所有桡骨均能承受 500N 的压缩负荷。导致失效的平均压缩力为 2.56 kN（范围 1.30-7.32）。平均刚度为 3.5 kN/mm（范围 2.0-4.9）。记录了 11 例桡骨颈骨折和 7 例桡骨颈和桡骨头粉碎性骨折。78%的测试桡骨前外侧象限受累。
在前臂中立位时，桡骨头的前外侧象限（前外侧象限）被证实是生物力学环境中关节桡骨头骨折最常见的部位。在手臂伸展摔倒的情况下，由于先前发生的桡骨颈和头骨折，应明确排除桡骨颈骨折。
