Biomechanics of distal radius fracture instability

Achieving fracture stability is a prerequisite for attaining a satisfactory outcome for distal radius fractures. Unstable fractures are at increased risk for loss of reduction and subsequent malunion. Malunion can potentially lead to a poor functional outcome with residual pain, loss of motion, decreased endurance and grip strength, midcarpal instability, and post-traumatic arthritis. Except for confusing and poorly reproducible radiographic criteria, no biomechanical definition of fracture instability exists. The purpose of this study was to provide insight into factors influencing distal radius fracture stability. Specifically, the study investigated the impacts of soft tissue injury, fracture comminution, and bone quality on fracture stability.