Department of Pediatric Orthopaedics and Foot and Ankle Surgery, Orthopaedic Hospital Speising, Vienna, Austria.
Krankenhaus der Barmherzigen Schwestern Ried, Ried, Austria.
Arch Orthop Trauma Surg. 2023 May;143(5):2437-2446. doi: 10.1007/s00402-022-04460-y. Epub 2022 May 9.
This study investigated the anatomic feasibility of a new surgical therapy option for radial head arthrosis using an autologous vascularized bone graft of the second metatarsal and proximal fibula to recreate the proximal radiohumeral joint.
Upper and lower extremities of eleven body donors were evaluated using CT prior to anatomic dissection. Several distinct anatomic parameters were measured on the ipsi- and contralateral radial and fibular head and the second metatarsal base: bone diameter, articular surface diameter, head height, metaphyseal (neck) diameter, articular surface radius, total articular surface area, and angulation of the articular surfaces (facet). Each dissection phase was photographed in a standardized fashion and all measurements were repeated by direct caliper-measurements.
When comparing the proximal radius and fibula to search for anatomic similarities, similar values were found in the maximum articular surface diameter and minimum and maximum measures of the neck diameter. Comparing the proximal radius and the second metatarsal, statistically similar values were found in the maximum neck diameter performing direct measurements and CT evaluation, the maximum head diameter in CT evaluation and the articular facet angulation.
Neither the proximal fibula nor the base of the second metatarsal are ideal bone grafts for replacement of the head of the radius. The base of the second metatarsal might be a bit more suitable as a potential donor since the angulation of the proximal articular facet is similar to that of the radius.
Level IV, anatomic study.
本研究通过使用自体第二跖骨和腓骨近端带血管骨移植来重建近桡尺关节，为桡骨头关节炎提供了一种新的手术治疗选择，探讨了其解剖学可行性。
在进行解剖学研究之前，对 11 具尸体标本的上下肢进行 CT 评估。在同侧和对侧桡骨和腓骨头以及第二跖骨基底上测量了几个明显的解剖参数：骨直径、关节面直径、头高、干骺端（颈）直径、关节面半径、总关节面面积以及关节面（关节突）的角度。每个解剖阶段均以标准化方式拍照，所有测量值均通过直接卡尺测量进行重复。
在比较近侧桡骨和腓骨以寻找解剖相似性时，在最大关节面直径和颈直径的最小和最大测量值方面发现了相似的值。在直接测量和 CT 评估时，比较近侧桡骨和第二跖骨的最大颈直径、CT 评估中的最大头直径和关节突面角度，发现了统计学上相似的值。
近侧腓骨和第二跖骨基底都不是桡骨头置换的理想骨移植物。由于近侧关节突面的角度与桡骨相似，第二跖骨基底可能更适合作为潜在的供体。
IV 级，解剖学研究。
