桡骨远端的三维成像与掌侧锁定板手术相关。

Three-dimensional imaging of the distal radius with reference to volar locking plate surgery.

机构信息

Iwate Medical University, Iwate Ika Daigaku, Japan.

出版信息

Orthop Traumatol Surg Res. 2022 Nov;108(7):103372. doi: 10.1016/j.otsr.2022.103372. Epub 2022 Aug 2.

DOI:10.1016/j.otsr.2022.103372

PMID:35931376

Abstract

BACKGROUND

The watershed line is widely accepted as the distal limit of the volar locking plate (VLP); however, the VLP placement could vary depending on the plate contour and morphology of the distal radius. The aim of this study was to investigate the morphology of the distal radius and VLP fitting using 3D images.

HYPOTHESIS

We hypothesized that attachment of the VLP would affect the contour of the volar prominence of the distal radius.

PATIENTS AND METHODS

Variable-angle LCP two-column volar distal radius Plate 2.4 and 16 formalin-fixed cadavers were studied. The plate and forearm were scanned using a computed tomography scanner. The plate was fixed to the radial shaft in the most distal position without flexor pollicis longus tendon contact. Postero-antero and lateral radiographs were obtained using fluoroscopy. Postero-antero radiographs were superimposed on a 3D image of the distal radius. The virtual plate was attached to the distal radius in the computer simulations and the plate was adjusted in the sagittal plane. In the postero-antero radiographs, the distance between the plate and distal end of the radius (DPR) was measured. In the sagittal plane, the height of the volar lunate facet (VLF) and the plate-to-bone distance of each locking screw hole was measured. The volar cortical angle (VCA) was measured as the angle formed by a line drawn along the volar surface and a line drawn on the radial shaft on the sagittal plane at each locking screw plane.

RESULTS

A significant correlation was observed between the height of the VLF and the DPR and between the height of the VLF and the VCA. The plate-to-bone distance at the ulnar screw hole was significantly smaller than that of the other screw holes.

DISCUSSION

Our study revealed that the higher the VLF, the more proximal is the VLP. The plate fits on the bone surface at the ulnar side, whereas the radial side has more space between the plate and bone.

LEVEL OF EVIDENCE

III, diagnostic Level.

摘要

背景

分水岭线被广泛认为是掌侧锁定板（VLP）的远端极限；然而，VLP 的放置位置可能因钢板轮廓和远端桡骨形态而异。本研究旨在通过 3D 图像研究远端桡骨的形态和 VLP 适配。

假说

我们假设 VLP 的附着会影响远端桡骨掌侧突出的轮廓。

患者和方法

研究了可变角度 LCP 双柱掌侧远端桡骨 2.4 和 16 个福尔马林固定的尸体。使用计算机断层扫描（CT）扫描仪对钢板和前臂进行扫描。将钢板固定在桡骨远端，不接触拇长屈肌腱。使用透视法获得前后位和侧位 X 线片。将前后位 X 线片叠加到远端桡骨的 3D 图像上。在计算机模拟中，将虚拟钢板附着在远端桡骨上，并在矢状面调整钢板。在前后位 X 线片上，测量钢板与桡骨远端（DPR）之间的距离。在矢状面上，测量月骨掌面高度（VLF）和每个锁定螺钉孔的钢板到骨的距离。在每个锁定螺钉平面的矢状面上，测量背侧桡侧皮质角（VCA），该角由沿掌面绘制的线和沿桡骨轴绘制的线形成。