Regional differences in the three-dimensional bone microstructure of the radial head: implications for observed fracture
- PDF / 1,643,552 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 50 Downloads / 157 Views
TRAUMA SURGERY
Regional differences in the three‑dimensional bone microstructure of the radial head: implications for observed fracture patterns Jetske Viveen1,2 · Egon Perilli3 · Ruurd L. Jaarsma1 · Job N. Doornberg1,2,4 · Denise Eygengaal2,5 · Gregory I. Bain1 Received: 23 February 2020 / Accepted: 15 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction A characterization of the internal bone microstructure of the radial head could provide a better understanding of commonly occurring fracture patterns frequently involving the (antero)lateral quadrant, for which a clear explanation is still lacking. The aim of this study is to describe the radial head bone microstructure using micro-computed tomography (micro-CT) and to relate it to gross morphology, function and possible fracture patterns. Materials and methods Dry cadaveric human radii were scanned by micro-CT (17 μm/pixel, isotropic). The trabecular bone microstructure was quantified on axial image stacks in four quadrants: the anterolateral (AL), posterolateral (PL), posteromedial (PM) and anteromedial (AM) quadrant. Results The AL and PL quadrants displayed the significantly lowest bone volume fraction and trabecular number (BV/TV range 12.3–25.1%, Tb.N range 0.73–1.16 mm−1) and highest trabecular separation (Tb.Sp range 0.59–0.82 mm), compared to the PM and AM quadrants (BV/TV range 19.9–36.9%, Tb.N range 0.96–1.61 mm−1, Tb.Sp range 0.45–0.74 mm) (p = 0.03). Conclusions Our microstructural results suggest that the lateral side is the “weaker side”, exhibiting lower bone volume faction, less trabeculae and higher trabecular separation, compared to the medial side. As the forearm is pronated during most falls, the underlying bone microstructure could explain commonly observed fracture patterns of the radial head, particularly more often involving the AL quadrant. If screw fixation in radial head fractures is considered, surgeons should take advantage of the “stronger” bone microstructure of the medial side of the radial head, should the fracture line allow this. Keywords Elbow · Radial head · Fracture · Micro-CT · Trabeculae
Introduction Although many anatomical and imaging studies on the gross anatomy of the proximal radius have been published [1–6], only two studies used high-resolution three-dimensional * Jetske Viveen [email protected] 1
Department of Orthopedic and Trauma Surgery, College of Medicine and Public Health Flinders University and Flinders Medical Centre, Adelaide, SA 5042, Australia
2
Department of Orthopedic Surgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands
3
Medical Device Research Institute, College of Science and Engineering, Flinders University, Tonsley, SA 5042, Australia
4
Groningen University, Groningen University Medical Centre, Groningen, The Netherlands
5
Upper Limb Unit, Department of Orthopedic Surgery, Amphia Hospital, Breda, The Netherlands
(3D) imaging methods such as micro-computed tomography (micro-CT) [7, 8]. In these studie
Data Loading...
