A feasible and cost-effective method to induce distal radius fractures in full-length forearm human cadaveric specimens.

INTRODUCTION: Reported rates of loss of reduction in nonoperatively treated distal radius fractures (DRF) range from 17 to 71%. Thus, realistic biomechanical models are warranted to test novel immobilization devices that prevent loss of reduction in nonoperative fracture management. Currently available human cadaveric specimen models have several limitations: (i) disrupted soft tissue integrity, (ii) difficulty in replicating complex fracture patterns, and (iii) high technical demands and costs. Therefore, the aim of this study was to establish a feasible and accessible method for inducing DRFs, that accurately reflects in-vivo biomechanical fracture conditions in tissue-intact cadaveric specimens, suitable for testing of novel immobilization devices.

MATERIALS AND METHODS: Fifteen upper extremity cadaveric specimens were included. Specimens were prepared as full‑length forearm models. Using a repurposed strength training tower as a vertical drop tower, fractures were induced by proximally administering 120-135 J impacts. CT scans were performed pre- and post-fracture induction. All fractures were classified according to the AO/OTA classification.

RESULTS: DRFs were successfully induced in all 15 specimens. A single 120 J impact produced a DRF in 11 out of 15 cases (73%). A second impact was administered in 4 out of 15 specimens (27%). Eleven of the 15 induced DRFs (73%) were classified as AO/OTA type C fractures, most commonly 2R3C3.2. Concomitant distal ulnar fractures were present in 6 cases, concomitant carpal fractures in 9 specimens. The overall cost of the setup amounted to 947 €.

CONCLUSIONS: This study presents a feasible, cost-effective method to induce DRFs in tissue-intact, full-length human cadaveric forearm specimens. The setup consistently produces DRFs, predominantly AO/OTA type C, which can, with certain limitations, be utilized for biomechanical testing of immobilization devices, while also being uited for surgical and anatomical education.