Zhao Hongru, Herman Benjamin, Adeeb Samer, Sheps David, El-Rich Marwan
Department of Civil and Environmental Engineering, University of Alberta, Canada.
Clin Biomech (Bristol). 2013 Jul;28(6):626-34. doi: 10.1016/j.clinbiomech.2013.05.004. Epub 2013 Jun 12.
The proximal tibiofibular joint can be used as a source of osteochondral autograft with little to no morbidity at the harvest site.
CT scans of fourteen left and seven right fibular heads, seven right and six left ulnas obtained from healthy subjects were volume-scaled and analyzed. Ipsilateral ulnar articular surfaces were compared between subjects and contralateral ulnas were compared within the same subject. The average deviations between the surfaces were measured. Manual registration and best-fit alignment were used to locate the area on the fibular heads that would best-fit the 50% coronoid process surface.
The average deviations in the articular surface between subjects were (mean (SD) 0.79mm (0.17) and 0.76mm (0.14) for the left and right ulnas respectively and 0.35mm (0.07) in the same subject. The average coronoid process height of the scaled ulnas was 15.92mm (1.15). When comparing the 50% coronoid process with the ispsilateral fibular head geometries, the maximum deviations for all subjects were smaller than 2.0mm. Two locations were identified as the best-fit locations.
When volume-scaled, the articular congruency of the proximal ulna articular surfaces between subjects is within the allowable limit for a typical intra-articular fracture step. Results suggest it is possible to use the CT scan of a patient's contralateral elbow as a template to estimate the morphology of the affected side. The fibular head could be an alternative replacement for damaged coronoid process since it is covered by articular cartilage and has locations with a similar curvature as the coronoid process.
胫腓近端关节可作为自体骨软骨移植的来源，取骨部位几乎没有或完全没有并发症。
对从健康受试者获取的14个左侧和7个右侧腓骨头、7个右侧和6个左侧尺骨进行CT扫描，进行体积缩放并分析。比较受试者之间的同侧尺骨关节面，并在同一受试者内比较对侧尺骨。测量表面之间的平均偏差。使用手动配准和最佳拟合对齐来确定腓骨头上最适合50%冠突表面的区域。
受试者之间关节面的平均偏差分别为：左侧尺骨0.79mm（标准差0.17），右侧尺骨0.76mm（标准差0.14），同一受试者内为0.35mm（标准差0.07）。缩放后尺骨的平均冠突高度为15.92mm（标准差1.15）。将50%冠突与同侧腓骨头几何形状进行比较时，所有受试者的最大偏差均小于2.0mm。确定了两个最佳拟合位置。
进行体积缩放时，受试者之间近端尺骨关节面的关节一致性在典型关节内骨折台阶的允许范围内。结果表明，有可能将患者对侧肘部的CT扫描用作模板来估计患侧的形态。腓骨头可作为受损冠突的替代物，因为它被关节软骨覆盖，且有与冠突曲率相似的位置。
