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ANATOMICAL ARCHITECTURE AND ANGULATIONS OF THE PROXIMAL ULNA

Year 2021, , 419 - 426, 13.09.2021
https://doi.org/10.17343/sdutfd.819033

Abstract

Objective
We aimed to get morphometric data of the proximal
ulna, besides torsion angle, which is rarely found in
the literature.
Materials and Methods
In this study, 25 ulna (11 left, 14 right) found in the
Anatomy Department laboratory were used. Eight
morphometric parameters of the proximal ulna
were measured. All dry bones were photographed
using a ruler and transferred to the computer. Then,
morphometric measurements were made with the
help of Image-J analysis program.
Results
In our measurement we noted that the mean ulna
length was 251.02 ± 16.23 mm and the mean ulna
length except trochlear notch was 223.49 ± 15.52
mm. The mean radial notch width was 18.5 ± 3.38
mm, the mean radial notch height was 12.09 ± 1.70
mm, and the mean trochlear notch depth was 11.57
± 1.73 mm. Mean torsion angle, dorsal angulation
and varus angle were calculated respectively; 14.64
± 8.36º; 5.94º ± 2.01º; 12.48º ± 2.425º. There was no
statistically significant difference in any parameter in
the comparison between the sides.
Conclusion
The anatomical shape of the proximal ulna causes
specific difficulties for implants used in humeroulnar
arthroplasty. The fact that there is no difference
between the right and left sides in all parameters
in this study suggests that the knowledge of the
opposite side ulna can be used in the appropriate
prosthesis design. In addition, the results of this study
will provide data on ulna dimensions in forensic and
anthropological studies.

References

  • Beşer CG, Demiryürek D, Özsoy H, Erçakmak B, Hayran M, Kızılay O, et al. Redefining the proximal ulna anatomy. Surg Radiol Anat. 2014;36(10):1023–31.
  • Brownhill JR, Mozzon JB, Ferreira LM, Johnson JA, King GJW. Morphologic analysis of the proximal ulna with special interest in elbow implant sizing and alignment. J Shoulder Elb Surg. 2009;18(1):27–32. http://dx.doi.org/10.1016/j.jse.2008.03.008
  • Totlis T, Anastasopoulos N, Apostolidis S, Paraskevas G, Terzidis I, Natsis K. Proximal ulna morphometry: which are the “true” anatomical preshaped olecranon plates? Surg Radiol Anat. 2014;36(10):1015–22.
  • Rouleau DM, Faber KJ, Athwal GS. The proximal ulna dorsal angulation: A radiographic study. J Shoulder Elb Surg. 2010;19(1):26–30. http://dx.doi.org/10.1016/j.jse.2009.07.005
  • Jaehon K, Mudgal C, Konopka J, Jup J. Complications of total elbow arthroplasty J Am Acad Orthop Surg. 2011;19(6):328-39.
  • Gul H, Nizami SM, Khan MA. Estimation of Body Stature Using the Percutaneous Length of Ulna of an Individual. 2020;12(1):8–13.
  • Ilayperuma I, Nanayakkara G, Palahepitiya N. A Model for the Estimation of Personal Stature from the Length of Forearm. 2010;28(4):1081–6.
  • Windisch G, Clement H, Grechenig W, Tesch NP, Pichler W. The anatomy of the proximal ulna. J Shoulder Elb Surg. 2007 Sep;16(5):661–6. https://linkinghub.elsevier.com/retrieve/pii/S1058274607002388
  • Bailey CS, MacDermid J, Patterson SD, King GJW. Outcome of plate fixation of olecranon fractures. J Orthop Trauma. 2001;15(8):542–8.
  • Lavigne G, Baratz M. Fractures of the olecranon. J Am Soc Surg Hand. 2004;4(2):94–102.
  • Nowinski RJ, Nork SE, Segina DN, Benirschke SK. Comminuted fracture-dislocations of the elbow treated with an AO wrist fusion plate. Clin Orthop Relat Res. 2000;(378):238–44.
  • Yong WJ, Tan J, Adikrishna A, Lee HJ, Jung JW, Cho DW, et al. Morphometric analysis of the proximal ulna using three-dimensional computed tomography and computer-aided design: varus, dorsal, and torsion angulation. Surg Radiol Anat. 2014;36(8):763–8.
  • Wang AA, Mara M, Hutchinson DT. The proximal ulna: An anatomic study with relevance to olecranon osteotomy and fracture fixation. J Shoulder Elb Surg. 2003;12(3):293–6.
  • Erdem H. Surgical importance of radiographically aided morphometry of the proximal ulna. Int J Morphol. 2020;38(2):299–304.
  • Grechenig W, Clement H, Pichler W, Tesch NP, Windisch G. The influence of lateral and anterior angulation of the proximal ulna on the treatment of a Monteggia fracture. J Bone Jt Surg - Ser B. 2007;89(6):836–8.
  • Cowal LS, Pastor RF. Dimensional Variation in the Proximal Ulna : Evaluation of a Metric Method for Sex Assessment. Am J Phys Anthropol Off Publ Am Assoc Phys Anthropol. 2008;135(4):469–78.
  • Ndou R, Schepartz LA. Morphometric Characteristics of the Humerus and Ulna in Limbs Bearing the Supratrochlear Aperture (STA). Anat Rec. 2016;299(2):220–33.
  • Sakaue K. Sexual determination of long bones in recent Japanese. Anthropol Sci. 2004;112(1):75–81.
  • Rouleau DM, Canet F, Chapleau J, Petit Y, Sandman E, Faber KJ, et al. The influence of proximal ulnar morphology on elbow range of motion. J Shoulder Elb Surg. 2012;21(3):384–8. http://dx.doi.org/10.1016/j.jse.2011.10.008

PROKSİMAL ULNA’NIN ANATOMİK MİMARİSİ VE AÇILANMALARI

Year 2021, , 419 - 426, 13.09.2021
https://doi.org/10.17343/sdutfd.819033

Abstract

Amaç
Literatürde az yer alan torsiyon açısı da dahil olmak
üzere proksimal ulna’ya ait diğer bazı morfometrik verilerin
elde edilmesi amaçlandı.
Gereç ve Yöntem
Bu çalışmada Anatomi Ana Bilim Dalı laboratuvarında
bulunan 25 ulna (11 sol, 14 sağ) kullanıldı. Proksimal
ulna'ya ait 8 morfometrik parametre ölçüldü. Tüm kuru
kemikler bir cetvel eşliğinde fotoğraflandı ve bilgisayara
aktarıldı. Daha sonra Image-J analiz programı
yardımıyla morfometrik ölçümler yapıldı.
Bulgular
Ortalama ulna uzunluğu 251,02±16.23 mm ve ortalama
incisura trochlearis hariç ulna uzunluğu
223,49±15.52 mm bulundu. Ortalama incisura radialis
genişliği 18,5±3.38 mm, ortalama incisura radialis
yüksekliği 12,09±1.70 mm ve ortalama incisura trochlearis
derinliği 11,57±1.73 mm bulundu. Ortalama torsiyon
açısı, dorsal açılanma ve varus açısı sırasıyla
14,64º±8.36º; 5,94º±2.01º; 12,48º±2.425º olarak hesaplandı.
Hiçbir parametrede taraflar arası karşılaştırmada
istatistiksel olarak anlamlı fark bulunmadı.
Sonuç
Proksimal ulna’nın anatomik şekli, humeroulnar artroplastide
kullanılan implantlar için özel zorluklar oluşturmaktadır.
Bu çalışmadaki tüm parametrelerde sağ
ve sol taraflar arasında fark olmaması, uygun protez
tasarımında karşı taraf ulna’nın bilgisinden yararlanılabileceğini
düşündürmektedir. Ayrıca bu çalışmanın
sonuçları, adli ve antropolojik araştırmalarda ulna boyutlarına
ilişkin veriler sağlayacaktır.

References

  • Beşer CG, Demiryürek D, Özsoy H, Erçakmak B, Hayran M, Kızılay O, et al. Redefining the proximal ulna anatomy. Surg Radiol Anat. 2014;36(10):1023–31.
  • Brownhill JR, Mozzon JB, Ferreira LM, Johnson JA, King GJW. Morphologic analysis of the proximal ulna with special interest in elbow implant sizing and alignment. J Shoulder Elb Surg. 2009;18(1):27–32. http://dx.doi.org/10.1016/j.jse.2008.03.008
  • Totlis T, Anastasopoulos N, Apostolidis S, Paraskevas G, Terzidis I, Natsis K. Proximal ulna morphometry: which are the “true” anatomical preshaped olecranon plates? Surg Radiol Anat. 2014;36(10):1015–22.
  • Rouleau DM, Faber KJ, Athwal GS. The proximal ulna dorsal angulation: A radiographic study. J Shoulder Elb Surg. 2010;19(1):26–30. http://dx.doi.org/10.1016/j.jse.2009.07.005
  • Jaehon K, Mudgal C, Konopka J, Jup J. Complications of total elbow arthroplasty J Am Acad Orthop Surg. 2011;19(6):328-39.
  • Gul H, Nizami SM, Khan MA. Estimation of Body Stature Using the Percutaneous Length of Ulna of an Individual. 2020;12(1):8–13.
  • Ilayperuma I, Nanayakkara G, Palahepitiya N. A Model for the Estimation of Personal Stature from the Length of Forearm. 2010;28(4):1081–6.
  • Windisch G, Clement H, Grechenig W, Tesch NP, Pichler W. The anatomy of the proximal ulna. J Shoulder Elb Surg. 2007 Sep;16(5):661–6. https://linkinghub.elsevier.com/retrieve/pii/S1058274607002388
  • Bailey CS, MacDermid J, Patterson SD, King GJW. Outcome of plate fixation of olecranon fractures. J Orthop Trauma. 2001;15(8):542–8.
  • Lavigne G, Baratz M. Fractures of the olecranon. J Am Soc Surg Hand. 2004;4(2):94–102.
  • Nowinski RJ, Nork SE, Segina DN, Benirschke SK. Comminuted fracture-dislocations of the elbow treated with an AO wrist fusion plate. Clin Orthop Relat Res. 2000;(378):238–44.
  • Yong WJ, Tan J, Adikrishna A, Lee HJ, Jung JW, Cho DW, et al. Morphometric analysis of the proximal ulna using three-dimensional computed tomography and computer-aided design: varus, dorsal, and torsion angulation. Surg Radiol Anat. 2014;36(8):763–8.
  • Wang AA, Mara M, Hutchinson DT. The proximal ulna: An anatomic study with relevance to olecranon osteotomy and fracture fixation. J Shoulder Elb Surg. 2003;12(3):293–6.
  • Erdem H. Surgical importance of radiographically aided morphometry of the proximal ulna. Int J Morphol. 2020;38(2):299–304.
  • Grechenig W, Clement H, Pichler W, Tesch NP, Windisch G. The influence of lateral and anterior angulation of the proximal ulna on the treatment of a Monteggia fracture. J Bone Jt Surg - Ser B. 2007;89(6):836–8.
  • Cowal LS, Pastor RF. Dimensional Variation in the Proximal Ulna : Evaluation of a Metric Method for Sex Assessment. Am J Phys Anthropol Off Publ Am Assoc Phys Anthropol. 2008;135(4):469–78.
  • Ndou R, Schepartz LA. Morphometric Characteristics of the Humerus and Ulna in Limbs Bearing the Supratrochlear Aperture (STA). Anat Rec. 2016;299(2):220–33.
  • Sakaue K. Sexual determination of long bones in recent Japanese. Anthropol Sci. 2004;112(1):75–81.
  • Rouleau DM, Canet F, Chapleau J, Petit Y, Sandman E, Faber KJ, et al. The influence of proximal ulnar morphology on elbow range of motion. J Shoulder Elb Surg. 2012;21(3):384–8. http://dx.doi.org/10.1016/j.jse.2011.10.008
There are 19 citations in total.

Details

Primary Language Turkish
Subjects Surgery, Clinical Sciences, Health Care Administration
Journal Section Research Articles
Authors

Kenan Öztürk This is me 0000-0002-5552-8684

Berfu Özdemir 0000-0001-5851-0300

Ahmet Dursun 0000-0003-4568-8761

Yadigar Kastamoni 0000-0002-3504-5853

Soner Albay 0000-0001-8438-8628

Publication Date September 13, 2021
Submission Date November 6, 2020
Acceptance Date March 9, 2021
Published in Issue Year 2021

Cite

Vancouver Öztürk K, Özdemir B, Dursun A, Kastamoni Y, Albay S. PROKSİMAL ULNA’NIN ANATOMİK MİMARİSİ VE AÇILANMALARI. Med J SDU. 2021;28(3):419-26.

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