title: The metaphyseal bone defect in distal radius fractures and its implication on trabecular remodeling-a histomorphometric study (case series).
abstract: BACKGROUND
  The invention of the locking plate technology leads to alterations of treatment strategies at metaphyseal fracture sites with the concept of spontaneous remodeling of trabecular bone voids. Whereas trabecular regeneration has been proven in experimental animal studies, no histologic data exist on human fracture healing with special emphasis on bone voids.
  
  
  METHODS
  In order to qualify the trabecular bone remodeling capacity in vivo, bone specimens from the metaphyseal bone void were analyzed 14 months after trauma using quantitative histomorphometry. Twenty-five patients with an unstable dorsally displaced distal radius fracture were fixed with a palmar locking plate without additional bone graft or substitute. At implant removal, specimens from the previous compression void were harvested with a trephine in a volar-dorsal direction. In 16 patients, histomorphometric analysis could be performed, comparing the dorsal trabecular network with the volar, non-compressed ultrastructure.
  
  
  RESULTS
  Significant differences for bone volume/total volume (BV/TV), trabecular number (TbN) and trabecular separation (TbSp), but not for trabecular thickness (TbTh) and osteoid volume/total volume (OV/TV), were detected. Neither patient age, defect size nor gender had a significant influence on bone remodeling.
  
  
  CONCLUSIONS
  The results of this study indicate that trabecular bone remodeling does not lead to pre-trauma bone quality in metaphyseal bone compression voids following reduction and application of a locking plate.
authors.affiliation: Department for Trauma Surgery, LK Baden Mödling, Sr. M. Restituta Gasse 12, 2340, Mödling, Austria. martin.lutz@moedling.lknoe.at.
authors.forename: Martin
authors.initials: M
authors.lastname: Lutz
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology Brisbane, 60 Musk Avenue, Kelvin Grove QLD, 4059, Brisbane, Australia. r.steck@qut.edu.au.
authors.forename: Roland
authors.initials: R
authors.lastname: Steck
authors.affiliation: Department for Trauma Surgery, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. ingrid.sitte@i-med.ac.at.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Sitte
authors.affiliation: Department for Radiology General Hospital Hall in Tirol, Milser Strasse 10, 6060, Hall in Tirol, Austria. michael.rieger@tilak.at.
authors.forename: Michael
authors.initials: M
authors.lastname: Rieger
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology Brisbane, 60 Musk Avenue, Kelvin Grove QLD, 4059, Brisbane, Australia. m.schuetz@qut.edu.au.
authors.forename: Michael
authors.initials: M
authors.lastname: Schuetz
authors.affiliation: Department for Trauma Surgery, LK Baden Mödling, Sr. M. Restituta Gasse 12, 2340, Mödling, Austria. thomas.klestil@moedling.lknoe.at.
authors.forename: Thomas
authors.initials: T
authors.lastname: Klestil
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001861:Bone Regeneration; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011884:Radius / Q000648:ultrastructure*; D011885:Radius Fractures / Q000473:pathology*; D055815:Young Adult