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Peer-reviewedCC BY 4.0Archives of Orthopaedic and Trauma Surgery

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

  • Julius Krüger1,2,3
  • Mads Terndrup4
  • Morten Grove Thomsen1
  • Arvind von Keudell5,6,7
  • Jonas Askø Andersen6,8,9
  • Tazio Maleitzke1,2,3,6
9 affiliations
  1. 1Trauma Orthopaedic Research Copenhagen Hvidovre (TORCH), Department of Orthopaedic Surgery, Copenhagen University Hospital – Amager and Hvidovre, Hvidovre, Denmark
  2. 2Center for Musculoskeletal Surgery, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
  3. 3Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Julius Wolff Institute, Berlin, Germany
  4. 4Exo360, Copenhagen, Denmark
  5. 5Department of Orthopaedic Surgery, Copenhagen University Hospital – Bispebjerg, Copenhagen, Denmark
  6. 6Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
  7. 7Department of Orthopaedic Surgery, Brigham and Women’s Hospital, MassGeneral Brigham Harvard Medical School, Boston, USA
  8. 8Department of Orthopaedic Surgery, Copenhagen University Hospital – North Zealand Hospital, Hillerød, Denmark
  9. 9Steno Diabetes Center Copenhagen, Copenhagen, Denmark
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Abstract

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.

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Cite

BibTeXRIS
BibTeX
@article{kruger2026feasible,
  title = {{A feasible and cost-effective method to induce distal radius fractures in full-length forearm human cadaveric specimens}},
  author = {Julius Krüger and Mads Terndrup and Morten Grove Thomsen and Arvind von Keudell and Jonas Askø Andersen and Tazio Maleitzke},
  journal = {Archives of Orthopaedic and Trauma Surgery},
  year = {2026},
  month = nov,
  doi = {10.1007/s00402-026-06549-0},
  url = {https://doi.org/10.1007/s00402-026-06549-0},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - A feasible and cost-effective method to induce distal radius fractures in full-length forearm human cadaveric specimens
AU  - Julius Krüger
AU  - Mads Terndrup
AU  - Morten Grove Thomsen
AU  - Arvind von Keudell
AU  - Jonas Askø Andersen
AU  - Tazio Maleitzke
PY  - 2026
DA  - 2026/11/03
JO  - Archives of Orthopaedic and Trauma Surgery
DO  - 10.1007/s00402-026-06549-0
UR  - https://doi.org/10.1007/s00402-026-06549-0
AB  - 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.
SN  - 0936-8051
SN  - 1434-3916
ER  -