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Anatomical Variations of the Proximal Radius and Their Effects on Osteosynthesis.
MedLine Citation:
PMID:  22459655     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: In fractures of the radial head and neck requiring open reduction and internal fixation, osteosynthesis may be safely applied in a limited zone. We conducted a morphometric study of the proximal radius at the level of the safe zone to identify different morphologic types of this anatomical region. METHODS: We analyzed 44 dried cadaveric radii. We measured the whole length of the radius, the length of the neck and head, and the minimum and maximum diameter of the radial head. The morphologic aspect of the neck-head curvature of the safe zone was evaluated qualitatively and quantitatively. RESULTS: The proximal radius at the level of the safe zone exhibited different radii of bending. In particular, we identified a morphologic type A, which showed a flat profile (25% of cases), morphologic types B and C, which showed a low concave curvature (64%), and a marked concave curvature (11%), respectively, of the safe zone. CONCLUSIONS: The profile of the proximal radius in the safe zone shows substantial morphologic variations that should be taken into account when operating on fractures of the proximal radius, to avoid malunions, pain, and stiffness of the elbow joint. A preoperative radiograph of the contralateral uninjured radius may be helpful in selecting the most appropriate internal fixation device to reconstruct the proximal radius after comminuted fractures. CLINICAL RELEVANCE: Knowledge of the proper bending radius of the safe zone allows the surgeon to select the most appropriate plate, and to achieve good fracture reduction and anatomical restoration of the proximal radius.
Authors:
Giuseppe Giannicola; Erica Manauzzi; Federico M Sacchetti; Alessandro Greco; Gianluca Bullitta; Annarita Vestri; Gianluca Cinotti
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-28
Journal Detail:
Title:  The Journal of hand surgery     Volume:  -     ISSN:  1531-6564     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Affiliation:
Departments of Orthopaedic Surgery and Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy.
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