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RESEARCH PRODUCT

Intramedullary nailing vs. palmar locked plating for unstable dorsally comminuted distal radius fractures: A biomechanical study

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Abstract Background The purpose of this study was to compare the stability of a 2.4 mm palmar locking compression plate and a new intramedullary nail-plate-hybrid Targon DR for dorsally comminuted distal radius fractures. Methods An extraarticular 10 mm dorsally open wedge osteotomy was created in 8 pairs of fresh frozen human radii to simulate an AO–A3-fracture. The fractures were stabilized using one of the fixation methods. The specimens were loaded axially with 200 N and dorsal-excentrically with 80 N. 2000 cycles of dynamic loading and axial loading-to-failure were performed. Findings Axial loading revealed that intramedullary osteosynthesis (Targon DR: 369 N/mm) was significantly ( p  = 0.017) stiffer than plate osteosynthesis (Locking compression plate: 131 N/mm). With 214 N/mm the intramedullary nail also showed higher stability during dorsal excentric loading than the Locking compression plate with 51 N/mm ( p  = 0.012). After 2000 cycles of axial loading with 80 N the Targon DR-group was significantly stiffer than the Locking compression plate-group under both loading patterns. Neither group showed significant changes in stiffness after 2000 cycles. Under dorsal excentric loading the Targon DR-group was still significantly stiffer with 212 N/mm than the Locking compression plate-group with 45 N/mm ( p  = 0.012). The load to failure tests demonstrated higher stability of intramedullary nailing (625 N) when compared to plate osteosynthesis (403 N) ( p Interpretation The study shows that intramedullary fixation of a distal AO–A3 radial fracture is biomechanically more stable than volar fixed-angle plating under axial and dorsal-excentric loading in an experimental setup.