• S Erhart, W Schmoelz, and M Lutz.
• Department for Trauma Surgery, Medical University Innsbruck, Anichstrasse 35, Innsbruck, Tyrol, Austria. stefanie.erhart@uki.at
• Arch Orthop Trauma Surg. 2013 Sep 1;133(9):1249-55.

IntroductionAfter fracture, distal radius malunion with dissociation of the volar and dorsal ulnar fracture fragments can lead to an increased articular cavity.Patients And MethodsTo investigate its clinical impact we retrospectively analyzed the outcome of 81 patients and simulated this form of malunion in a biomechanical experiment with six cadaver specimens in a dynamic loading set-up.ResultsIn clinics, a higher arthritis stage was significantly correlated with an increased articular cavity depth and an increased anterioposterior distance. In cadaver specimens, a significantly decreased range of motion and significantly altered intraarticular contact characteristics were recognized for an increased cavity.ConclusionAlterations in contact biomechanics could be one reason for the higher incidence of posttraumatic osteoarthritis when a deeper central impaction of the distal radius is present. From a clinical and experimental point of view, restoration of the normal shape of the distal radius is considered to minimize the risk for posttraumatic radiocarpal osteoarthritis.

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