{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:51:24Z","timestamp":1790286684633,"version":"4.1.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005788","name":"Medical University of Vienna","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["International Orthopaedics (SICOT)"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Removal of volar locking plates after healing of a distal radius fracture is becoming increasingly common. However, it is unclear how the fracture healing proceeds and which defects remain. The aim of this study was to assess changes in bone microarchitecture and biomechanical properties in surgically treated radius fracture after volar locking plate removal.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Twelve patients were recruited after undergoing plate removal. High Resolution Quantitative Computed Tomography (HR-pQCT) was used to perform scans of the fractured and contralateral distal radius on average one (M1) and 16 months (M2) after plate removal. Parameters measured were cortical- (Dcomp), trabecular- (Dtrab) and total bone density (D100), as well as cortical thickness (Ct.Th). Axial bone stiffness (FE.Kaxial) was determined through linear micro-finite element analysis (\u00b5FEA).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>At M1, no significant differences between fractured and contralateral side were detected except for Dcomp. At the fractured side, all parameters except for Dtrab increased significantly between M1 and M2. At M2, Ct.Th and FE.Kaxial were significantly higher at the fractured side compared to the contralateral side, but Dcomp remained significantly lower. Qualitatively, closure of the screw holes was observed between M1 and M2, while large trabecular defects remained.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Bone (re)modeling at the distal radius is an ongoing process even after plate removal and leads to a partial exaggeration of the bone properties relative to the intact contralateral side. It seems that the bone regains its biomechanical competence by closing screw holes and increasing cortical thickness, which compensates for trabecular defects that cannot be repaired.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of evidence<\/jats:title>\n            <jats:p>III.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00264-025-06529-w","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T08:23:24Z","timestamp":1744619004000},"page":"1509-1517","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Changes in bone density, microarchitecture, and biomechanical properties after plate removal in surgically treated distal radius fractures: a prospective study"],"prefix":"10.1007","volume":"49","author":[{"given":"Arastoo","family":"Nia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Hajdu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhild","family":"Thalhammer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silke","family":"Aldrian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenik","family":"Popp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Schm\u00f6lz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Haider","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieter","family":"Pahr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Synek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"6529_CR1","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/J.HCL.2012.02.001","volume":"28","author":"KW Nellans","year":"2012","unstructured":"Nellans KW, Kowalski E, Chung KC (2012) The epidemiology of distal radius fractures. Hand Clin 28:113\u2013125. https:\/\/doi.org\/10.1016\/J.HCL.2012.02.001","journal-title":"Hand Clin"},{"key":"6529_CR2","doi-asserted-by":"publisher","first-page":"2297","DOI":"10.1007\/s00198-014-2766-6","volume":"25","author":"HP Dimai","year":"2014","unstructured":"Dimai HP, Svedbom A, Fahrleitner-Pammer A et al (2014) Epidemiology of distal forearm fractures in Austria between 1989 and 2010. Osteoporos Int 25:2297\u20132306. https:\/\/doi.org\/10.1007\/s00198-014-2766-6","journal-title":"Osteoporos Int"},{"key":"6529_CR3","doi-asserted-by":"publisher","first-page":"180","DOI":"10.5435\/00124635-201003000-00007","volume":"18","author":"DM Lichtman","year":"2010","unstructured":"Lichtman DM, Bindra RR, Boyer MI et al (2010) Treatment of distal radius fractures. J Am Acad Orthop Surg Mar 18:180\u2013189. https:\/\/doi.org\/10.5435\/00124635-201003000-00007","journal-title":"J Am Acad Orthop Surg Mar"},{"key":"6529_CR4","doi-asserted-by":"crossref","unstructured":"Abe Y, Tokunaga S, Moriya T (2017) Management of Intra-Articular distal radius fractures. Volar or Dorsal Locking Plate-Which Has Fewer Complications? Hand (N Y)","DOI":"10.1177\/1558944716675129"},{"key":"6529_CR5","doi-asserted-by":"crossref","unstructured":"Claes L, Reusch M, G\u00f6ckelmann M et al Metaphyseal fracture healing follows similar Biomechanical rules as diaphyseal healing. J Orthop Res 29:425\u2013432","DOI":"10.1002\/jor.21227"},{"key":"6529_CR6","doi-asserted-by":"crossref","unstructured":"Perren SM Evolution of the internal fixation of long bone fractures. The scientific basis of biological internal fixation: choosing a new balance between stability and biology. J Bone Jt Surg Br 84:1093\u20131110","DOI":"10.1302\/0301-620X.84B8.0841093"},{"key":"6529_CR7","doi-asserted-by":"crossref","unstructured":"JJA J, FL H, JJC A et al In the distal radius in postmenopausal women: A Follow-Up 2 years postfracture using. J Bone Min Res 31:1114\u20131122","DOI":"10.1002\/jbmr.2766"},{"key":"6529_CR8","doi-asserted-by":"crossref","unstructured":"Lee J-K, Lee Y, Kim C et al Volar locking plate removal after distal radius fracture: a 10-year retrospective study. Arch Orthop Trauma Surg 141:1711\u20131719","DOI":"10.1007\/s00402-020-03637-7"},{"key":"6529_CR9","doi-asserted-by":"publisher","first-page":"2650","DOI":"10.1016\/J.INJURY.2017.10.010\/ATTACHMENT\/31F82BF7-A4FB-4EE4-8BF3-3CE199269551\/MMC2.DOCX","volume":"48","author":"M Yamamoto","year":"2017","unstructured":"Yamamoto M, Fujihara Y, Fujihara N, Hirata H (2017) A systematic review of volar locking plate removal after distal radius fracture. Injury 48:2650\u20132656. https:\/\/doi.org\/10.1016\/J.INJURY.2017.10.010\/ATTACHMENT\/31F82BF7-A4FB-4EE4-8BF3-3CE199269551\/MMC2.DOCX","journal-title":"Injury"},{"key":"6529_CR10","doi-asserted-by":"crossref","unstructured":"Yao CK, Lin KC, Tarng YW et al Removal of forearm plate leads to a high risk of refracture: decision regarding implant removal after fixation of the forearm and analysis of risk factors of refracture. Arch Orthop Trauma Surg 134:1691\u20131697","DOI":"10.1007\/s00402-014-2079-4"},{"key":"6529_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/OS.14307","volume":"0","author":"R Cao","year":"2024","unstructured":"Cao R, Zhang J, Sun W et al (2024) Removal of forearm plate leads to a higher risk of Refracture\u2014A systematic review and Meta-Analysis. Orthop Surg 0:1\u20139. https:\/\/doi.org\/10.1111\/OS.14307","journal-title":"Orthop Surg"},{"key":"6529_CR12","doi-asserted-by":"crossref","unstructured":"Mehrzad R, Kim DC Complication rate comparing variable angle distal locking plate to fixed angle plate fixation of distal radius fractures. Ann Plast Surg 77:623\u2013625","DOI":"10.1097\/SAP.0000000000000850"},{"key":"6529_CR13","doi-asserted-by":"crossref","unstructured":"Yamamoto M, Fujihara Y, Fujihara N Hirata H A systematic review of volar locking plate removal after distal radius fracture. Injury 48:2650\u20132656","DOI":"10.1016\/j.injury.2017.10.010"},{"key":"6529_CR14","doi-asserted-by":"crossref","unstructured":"Atkins PR, Stock K, Ohs N et al Formation dominates resorption with increasing mineralized density and time postfracture in cortical but not trabecular bone: A longitudinal HRpQCT imaging study in the distal radius. JBMR Plus 5","DOI":"10.1002\/jbm4.10493"},{"key":"6529_CR15","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1055\/S-0040-1715425","volume":"14","author":"A Kaneko","year":"2020","unstructured":"Kaneko A, Naito K, Obata H et al (2020) Influence of smoking in the clinical outcomes of distal radius fractures. J Hand Microsurg 14:212. https:\/\/doi.org\/10.1055\/S-0040-1715425","journal-title":"J Hand Microsurg"},{"key":"6529_CR16","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1016\/J.BONE.2011.10.003","volume":"50","author":"JB Pialat","year":"2012","unstructured":"Pialat JB, Burghardt AJ, Sode M et al (2012) Visual grading of motion induced image degradation in high resolution peripheral computed tomography: impact of image quality on measures of bone density and micro-architecture. Bone 50:111\u2013118. https:\/\/doi.org\/10.1016\/J.BONE.2011.10.003","journal-title":"Bone"},{"key":"6529_CR17","doi-asserted-by":"crossref","unstructured":"Agarwal S, Rosete F, Zhang C et al In vivo assessment of bone structure and estimated bone strength by first- and second-generation HR-pQCT. Osteoporos Int 27:2955\u20132966","DOI":"10.1007\/s00198-016-3621-8"},{"key":"6529_CR18","doi-asserted-by":"crossref","unstructured":"Manske SL, Zhu Y, Sandino C Boyd SK human trabecular bone microarchitecture can be assessed independently of density with second generation HR-pQCT. Bone 79:213\u2013221","DOI":"10.1016\/j.bone.2015.06.006"},{"key":"6529_CR19","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/J.RBRE.2014.07.010","volume":"55","author":"H Fuller","year":"2015","unstructured":"Fuller H, Fuller R, Pereira RMR (2015) High resolution peripheral quantitative computed tomography for the assessment of morphological and mechanical bone parameters. Rev Bras Reumatol (English Ed 55:352\u2013362. https:\/\/doi.org\/10.1016\/J.RBRE.2014.07.010","journal-title":"Rev Bras Reumatol (English Ed"},{"key":"6529_CR20","doi-asserted-by":"crossref","unstructured":"Varga P, Pahr DH, Baumbach S, Zysset PK HR-pQCT based FE analysis of the most distal radius section provides an improved prediction of Colles\u2019 fracture load in vitro. Bone 47:982\u2013988","DOI":"10.1016\/j.bone.2010.08.002"},{"key":"6529_CR21","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1016\/J.PARCO.2011.08.001","volume":"37","author":"C Flaig","year":"2011","unstructured":"Flaig C, Arbenz P (2011) A scalable memory efficient multigrid solver for micro-finite element analyses based on CT images. Parallel Comput 37:846\u2013854. https:\/\/doi.org\/10.1016\/J.PARCO.2011.08.001","journal-title":"Parallel Comput"},{"key":"6529_CR22","unstructured":"Virtanen P, Gommers R, Oliphant TE et al SciPy 1.0: fundamental algorithms for scientific computing in python. Nat Methods 17:261\u2013272"},{"key":"6529_CR23","doi-asserted-by":"crossref","unstructured":"Mattei L, Fonzo M, Marchetti S, Puccio F A quantitative and non-invasive vibrational method to assess bone fracture healing: a clinical case study. Int Biomech 8:1\u201313","DOI":"10.1080\/23335432.2021.1874528"},{"key":"6529_CR24","doi-asserted-by":"crossref","unstructured":"Bottlang M, Lesser M, Koerber J et al Far cortical locking can improve healing of fractures stabilized with locking plates. J Bone Jt Surg Am 92:1652\u20131660","DOI":"10.2106\/JBJS.I.01111"},{"key":"6529_CR25","doi-asserted-by":"publisher","unstructured":"Matsuura Y, Rokkaku T, Suzuki T et al (2017) Evaluation of bone atrophy after treatment of forearm fracture using nonlinear finite element analysis: A comparative study of locking plates and conventional plates. J Hand Surg Am 42. https:\/\/doi.org\/10.1016\/J.JHSA.2017.03.041.:659.e1-659.e9","DOI":"10.1016\/J.JHSA.2017.03.041"},{"key":"6529_CR26","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1097\/00003086-197111000-00026","volume":"81","author":"HK Uhthoff","year":"1971","unstructured":"Uhthoff HK, Dubuc FL (1971) Bone structure changes in the dog under rigid internal fixation. Clin Orthop Relat Res 81:165\u2013170. https:\/\/doi.org\/10.1097\/00003086-197111000-00026","journal-title":"Clin Orthop Relat Res"},{"key":"6529_CR27","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/0268-0033(88)90065-4","volume":"3","author":"JA Gilbert","year":"1988","unstructured":"Gilbert JA (1988) Stress protection osteopenia due to rigid plating. Clin Biomech 3:179\u2013186. https:\/\/doi.org\/10.1016\/0268-0033(88)90065-4","journal-title":"Clin Biomech"},{"key":"6529_CR28","doi-asserted-by":"crossref","unstructured":"Terjesen T, Nordby A, Arnulf V (1986) The extent of stress-protection after plate osteosynthesis in the human tibia. Clin Orthop Relat Res:108\u2013112","DOI":"10.1097\/00003086-198606000-00020"},{"key":"6529_CR29","doi-asserted-by":"crossref","unstructured":"Lujan TJ, Henderson CE, Madey SM et al Locked plating of distal femur fractures leads to inconsistent and asymmetric callus formation. J Orthop Trauma 24:156\u2013162","DOI":"10.1097\/BOT.0b013e3181be6720"},{"key":"6529_CR30","doi-asserted-by":"crossref","unstructured":"Spanswick P, Whittier D, Kwong C et al Restoration of stiffness during fracture healing at the distal radius, using HR-pQCT and finite element methods. J Clin Densitom 24:422\u2013432","DOI":"10.1016\/j.jocd.2020.12.003"},{"key":"6529_CR31","doi-asserted-by":"publisher","unstructured":"Zheng L, Huang X, Li C et al (2022) 3D printed trabeculae conditionally reproduce the mechanical properties of the actual trabeculae - A preliminary study. Heliyon 8. https:\/\/doi.org\/10.1016\/J.HELIYON.2022.E12101","DOI":"10.1016\/J.HELIYON.2022.E12101"}],"container-title":["International Orthopaedics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-025-06529-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00264-025-06529-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00264-025-06529-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T13:02:52Z","timestamp":1747227772000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00264-025-06529-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,14]]},"references-count":31,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["6529"],"URL":"https:\/\/doi.org\/10.1007\/s00264-025-06529-w","relation":{},"ISSN":["0341-2695","1432-5195"],"issn-type":[{"value":"0341-2695","type":"print"},{"value":"1432-5195","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,14]]},"assertion":[{"value":"7 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 April 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Study was approved by the medical ethical review committee (protocol number 2105\/2018). The procedures followed were in accordance with the Helsinki Declaration of 1975, as revised in 2000.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}