Totlis Trifon, Anastasopoulos Nikolaos, Apostolidis Stylianos, Paraskevas George, Terzidis Ioannis, Natsis Konstantinos
Laboratory of Anatomy, Medical School, Aristotle University of Thessaloniki, 54124, Thessaloníki, Macedonia, Greece,
Surg Radiol Anat. 2014 Dec;36(10):1015-22. doi: 10.1007/s00276-014-1287-5. Epub 2014 Mar 27.
To define the optimum design of the anatomical preshaped olecranon plate.
The geometry of the proximal ulna was studied in 200 paired Caucasian ulnae, using a digital caliper and goniometer. Gender and side differences were analyzed. Results were compared with the corresponding geometrical parameters of three olecranon plates with different contour. All three plates were placed on the dorsal surface of a "model" ulna, i.e., a right dried ulna having osteometric parameters similar to the averages of our sample, and plate-to-bone fit was examined in two planes.
The proximal ulna had an 8.48° (2.1°-15.7°) mean varus angulation and an 8.49° (1.70°-14.10°) mean anterior angulation, located on average 8.19 cm (5.68-11.66 cm) and 8.63 cm (5.28-11.92 cm) distal to the bone's most proximal point, respectively. The mean olecranon angle was 110.34° (98.70°-125.80°) and the olecranon length was 1.58 cm on average (1.20-2.12 cm). Only the plate having both varus and anterior angulation presented a good plate-to-bone fit in both planes.
A "true" anatomical preshaped olecranon plate should have both varus and anterior angulation close to the average angulations of the normal ulna and located in a certain distance from its proximal edge. The olecranon part of the plate should primarily not exceed the olecranon length and secondarily be close to the average olecranon angle. We believe that such a plate may facilitate intraoperative restoration of the proximal ulna complex anatomy, when dealing with comminuted or Monteggia fractures, thus leading to better postoperative results.
确定解剖预塑形鹰嘴钢板的最佳设计。
使用数字卡尺和量角器对200对高加索人尺骨近端的几何形状进行研究。分析性别和左右侧差异。将结果与三种不同轮廓的鹰嘴钢板的相应几何参数进行比较。将所有三种钢板放置在“模型”尺骨的背侧，即一块右干尺骨，其骨测量参数与我们样本的平均值相似，并在两个平面上检查钢板与骨的贴合情况。
尺骨近端平均内翻角度为8.48°（2.1°-15.7°），平均前倾角为8.49°（1.70°-14.10°），分别位于距骨最近端平均8.19 cm（5.68-11.66 cm）和8.63 cm（5.28-11.92 cm）的远端。鹰嘴平均角度为110.34°（98.70°-125.80°），鹰嘴长度平均为1.58 cm（1.20-2.12 cm）。只有具有内翻和前倾角两者的钢板在两个平面上均呈现出良好的钢板与骨的贴合。
一个“真正的”解剖预塑形鹰嘴钢板应具有接近正常尺骨平均角度的内翻和前倾角，并位于距其近端边缘一定距离处。钢板的鹰嘴部分首先不应超过鹰嘴长度，其次应接近平均鹰嘴角度。我们认为，在处理粉碎性或孟氏骨折时，这样的钢板可能有助于术中恢复尺骨近端的复杂解剖结构，从而获得更好的术后效果。
