Patient health may be compromised, and health costs higher, when the same kind of stabilizing plate is used in a woman’s forearm as in a man’s after a bone break, say researchers at Western University’s Bone and Joint Institute.
Fractures of the distal radius, just above the wrist, are among the most common bone breaks – they often happen when people try to cushion a fall with their hands — and often require surgical implantation of a metal plate to help the bone heal.
“Because the dimensions of implants are made from aggregated measurements of both men and women, we know the plates don’t always fit the anatomy of either men or women,” said Mitchell Thom, who holds an MSC in clinical anatomy. “That can lead to complications that sometimes result in a second surgery to remove the plate, and then another period of extended rehabilitation. We also know that women have a higher rate of complications than men.”
Thom set out to understand why, through detailed anatomical studies that included CT scans and 3D modelling. He concluded that, even when women and men have the same length of bone, women’s bones have a slightly different shape and the measurements are different. “The fixation plate simply doesn’t fit the same way it does with men, and that’s often the cause of the pain and other complications. This research suggests we have to go beyond the one-size-fits-both mentality when it comes to implants,” Thom said.
Changing the plate’s construction to reflect the different dimensions of women’s forearms would help improve patient recovery from serious breaks – particularly in women who have osteoporosis and are more likely to break bones. It would also save costs that result from longer rehabilitation times and the possibility of second surgery for some patients, he said.
Thom’s work was supervised by Timothy Burkhart of Mechanical and Materials Engineering and the Fowler Kennedy Sports Medicine Clinic. Both Burkhart and Thom are members of Western’s Bone and Joint Institute. Thom’s work took place in collaboration with professor Emily Lalone and PhD candidate Jake Reeves, both of Mechanical and Materials Engineering, and Prof. Katherine Wilmore of Anatomy and Cell Biology. The research won him top prize for graduate research at the recent American Association of Anatomists conference in Chicago.
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