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Puchwein, P; Schildhauer, TA; Schöffmann, S; Heidari, N; Windisch, G; Pichler, W.
Three-dimensional morphometry of the proximal ulna: a comparison to currently used anatomically preshaped ulna plates.
J Shoulder Elbow Surg. 2012; 21(8):1018-1023
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Autor/innen der Med Uni Graz:
Pichler Wolfgang
Puchwein Paul
Windisch Gunther
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Abstract:
Background: Anatomically preshaped plates are increasingly used for stabilization of comminuted olecranon and Monteggia fractures. The purposes of this study were to investigate the morphology of the proximal ulna and to compare morphologic findings with geometry of 4 preshaped ulna plates. Materials and methods: Forty human elbows (mean age, 68 years; range, 21-98 years) were measured by 2 independent observers using 64-slice computed tomography scans and 3-dimensional measuring software. Results: Measurements showed a mean dorsal hook angle of 95.3 degrees +/- 9.0 degrees (range, 74.7 degrees-110.8 degrees) with gender-specific differences (mean, 92.2 degrees +/- 8.1 degrees in men and 98.3 degrees +/- 8.9 degrees in women; P = .029); a mean distance from the tip of the olecranon to the proximal edge of the ulna of 24.7 +/- 2.7 mm (range, 20-30.5 mm) with gender-specific differences (P = .00068); a mean varus angulation of 14.3 degrees +/- 3.6 degrees (range, 5.8 degrees-21.2 degrees); and a mean anterior angulation (proximal ulna dorsal angulation) of 6.2 degrees +/- 2.7 degrees (range, 1.0 degrees-11.2 degrees). The investigated plates offered a tolerable (+/- standard deviation) hook angle in 25% to 68%, an appropriate varus angulation in 0% to 20%, and an adequate anterior angulation in 23% to 88%. The intraclass correlation coefficient was between 0.74 and 0.91. Conclusion: The proximal ulna has a gender-specific and variable morphology. Some currently used anatomically preshaped proximal ulna plates differ significantly from these morphologic findings. In cases where reduction is not exactly possible, application of an "anatomically preshaped" plate may result in poor reduction. Especially in case of Monteggia fractures with instability of the radiocapitellar joint, surgeons could be misguided by plates that do not incorporate anterior angulation, resulting in subluxation of the radial head on the capitellum. Level of evidence: Basic Science Study, Anatomic Study, Imaging Study. (C) 2012 Journal of Shoulder and Elbow Surgery Board of Trustees.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Age Factors -
Aged -
Aged, 80 and over -
Bone Plates -
Cadaver -
Female -
Humans -
Imaging, Three-Dimensional -
Male -
Middle Aged -
Monteggia's Fracture - radiography Monteggia's Fracture - surgery
Observer Variation -
Olecranon Process - anatomy and histology Olecranon Process - radiography
Radiographic Image Enhancement -
Reproducibility of Results -
Sampling Studies -
Tomography, X-Ray Computed - methods
Ulna - anatomy and histology Ulna - radiography Ulna - surgery
Ulna Fractures - radiography Ulna Fractures - surgery
Young Adult -

Find related publications in this database (Keywords)
Preshaped ulna plates
morphometry of proximal ulna
Monteggia fracture
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