The effect of a wrist brace on injury patterns in experimentally produced distal radial fractures in a cadaveric model

We compared patterns of bony and ligamentous injury with distal radial fractures in braced and unbraced wrists using 20 paired fresh cadaveric upper extremities. A commercially available wrist brace was placed on one wrist in each pair. Specimens were then placed in a fast-loading gravity-driven device and subjected to loads averaging 16 kg from an average height of 78 cm. Postfracture radiographs were obtained, the specimens were dissected, and fracture patterns and ligamentous integrity were assessed. The following fracture types were produced: distal radial fractures (eight unbraced, seven braced) and intraarticular (seven unbraced, four braced). Radiographically, seven unbraced wrists demonstrated carpal bone fracture and one braced wrist demonstrated carpal fractures. Eight unbraced and three braced wrists sustained carpal intrinsic ligament injuries, four unbraced and one braced wrists demonstrated extrinsic ligament injuries. More capsular tears occurred in the unbraced group (N = 8) than in the braced group (N = 1). This model demonstrated a difference in the patterns of injury in unbraced and braced wrists subjected to the same mechanical conditions, which suggests that use of a wrist brace may alter patterns of wrist injury.