The Bioengineering Laboratory, Hand and Upper Limb Centre, St Joseph's Health Care, University of Western Ontario, London, ON, Canada.
J Shoulder Elbow Surg. 2013 Dec;22(12):1724-8. doi: 10.1016/j.jse.2013.06.014. Epub 2013 Sep 12.
There is no validated method to determine the correct diameter of a radial head implant when the radial head is too comminuted to function as a template or during revision surgery when the radial head has been previously excised. The purpose of this study was to determine if ipsilateral capitellar dimensions could be used to predict the diameter of the radial head; and hence to assist with implant selection.
Computer tomography scans of 50 normal elbows were used to generate 3D models. Measurements of the radial head included the maximum (Dmax) and minimum (Dmin) outer diameters and the maximum (Dishmax) and minimum (Dishmin) articular dish diameters. Measurements of the humerus included the width of the capitellum (CAPwidth), and the width from the lateral aspect of the capitellum to the lateral trochlear ridge (CAP-TROCHridge). Relationships were determined with Pearson bivariate coefficients.
The mean radial head dimensions were Dmax = 24.7 ± 2.3 mm, Dmin = 23.5 ± 2.3 mm, Dishmax = 18.2 ± 1.9 mm and Dishmin = 16.8 ± 1.7 mm. The mean capitellar measurements were CAPwidth (18.4 ± 1.4 mm) and CAP-TROCHridge (23.0 ± 2.1 mm). The most significant correlations were found between Dmax and CAP-TROCHridge (R = .90, P < .001) and Dmin and CAP-TROCHridge (R = .90, P < .001).
Radiologic measurements of the capitellum are useful in the estimation of native radial head diameter. The CAP-TROCHridge measurement was very strongly correlated with both the maximum and minimum diameters of the radial head. This suggests that CAP-TROCHridge may be useful to accurately predict the native radial head diameter. These morphological relationships were plotted to produce an implant selection chart for radial head sizing applicable to any implant system.
Basic science, anatomy study, CT imaging.
当桡骨头严重粉碎无法作为模板，或在桡骨头已被切除的翻修手术中，没有经过验证的方法来确定桡骨头植入物的正确直径。本研究的目的是确定同侧肱骨小头的尺寸是否可用于预测桡骨头的直径；并协助植入物的选择。
使用 50 个正常肘部的计算机断层扫描 (CT) 扫描生成 3D 模型。桡骨头的测量包括最大 (Dmax) 和最小 (Dmin) 外径以及最大 (Dishmax) 和最小 (Dishmin) 关节窝直径。肱骨的测量包括肱骨小头的宽度 (CAPwidth) 以及从肱骨小头的外侧到外侧滑车嵴的宽度 (CAP-TROCHridge)。使用 Pearson 双变量系数确定关系。
桡骨头的平均尺寸为 Dmax = 24.7 ± 2.3mm、Dmin = 23.5 ± 2.3mm、Dishmax = 18.2 ± 1.9mm 和 Dishmin = 16.8 ± 1.7mm。肱骨小头的平均测量值为 CAPwidth（18.4 ± 1.4mm）和 CAP-TROCHridge（23.0 ± 2.1mm）。Dmax 和 CAP-TROCHridge 之间（R =.90，P <.001）和 Dmin 和 CAP-TROCHridge 之间（R =.90，P <.001）发现了最显著的相关性。
肱骨小头的放射学测量在估计原生桡骨头直径方面很有用。CAP-TROCHridge 与桡骨头的最大和最小直径都非常密切相关。这表明 CAP-TROCHridge 可能有助于准确预测原生桡骨头直径。绘制这些形态关系图，为任何植入物系统生成桡骨头尺寸的植入物选择图表。
基础科学，解剖学研究，CT 成像。
