Relationship Between Ulnar Variance, Cortical Bone Density, and Load to Failure in the Distal Radius at the Typical Site of Fracture Initiation

Danielle J. Casagrande, Randal P. Morris, Nikoletta L. Carayannopoulos, William L. Buford

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose Increased ulnar variance has been shown to lead to diminished load borne by the distal radius. The purpose of this study was to determine the correlations among ulnar variance, bone mineral density, and load to failure at the distal radius. Methods Posteroanterior radiographs and computed tomographic scans were taken of 12 cadaveric forearms in neutral rotation. Ulnar variance was measured for each wrist by the method of perpendiculars. Measurements of cortical, trabecular, and combined bone density were made at the distal radius. We performed linear regression analysis and correlation analysis to determine the relationship between bone densities and ulnar variance measurements. Next, we loaded the 12 cadaveric radii to failure under axial compression. Linear regression analysis and correlation analysis were then performed to determine the relationship between load to failure and both ulnar variance and cortical density. Results Increased ulnar variance was significantly correlated with decreased cortical bone density at the distal radius and both were correlated with decreased load to failure. We found no correlation between ulnar variance and trabecular density or combined trabecular and cortical bone density at the distal radius. Conclusions Our study found that increased ulnar variance and decreased cortical bone mineral density correlates with decreased load to failure under axial compression. Clinical relevance Ulnar variance is linked to both bone quality and load to failure at the distal radius.

Original languageEnglish (US)
Pages (from-to)e461-e468
JournalJournal of Hand Surgery
Volume41
Issue number12
DOIs
StatePublished - Dec 1 2016
Externally publishedYes

Keywords

  • Bone mechanics
  • fracture
  • radius
  • ulna

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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