Mersin Şehir Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, El Cerrahisi Bölümü, 33240 Toroslar, Mersin, Türkiye.
Jt Dis Relat Surg. 2023;34(1):176-182. doi: 10.52312/jdrs.2023.872. Epub 2022 Dec 27.
This study aims to identify the most accurate dorsovolar principal axis of the distal radius and carpus identified on axial computed tomography (CT) sections and to establish normative data for angular measurements among these axes.
Between December 2019 and December 2021, normal axial CT images of wrists of a total of 42 individuals (25 males, 17 females; mean age: 31±8.4 years; range, 18 to 45 years) were retrospectively analyzed. Eight axes were identified on axial CT images: four distal radial axes (the volar cortical, medial cortical, central, and sigmoid notch axes) and four carpal axes (the scapholunate, lunotriquetral, capitohamate, and pisotrapezial axes). Twenty-two angular parameters were measured with reference to four principal axes (the volar cortical, medial cortical, central, and pisotrapezial axes).
The mean sigmoid notch rotation (version) angles relative to the four principal axes were 8±5° (range, -2° to 18°), 6±5° (range, -2° to 13°), 1±5° (range, -8° to 14°), and 4±4° (range, -3° to 15°), respectively. The mean scapholunate rotation angles were -13±5° (range, -27° to -6°), -15±6° (range, -29° to -8°), -21±5° (range, -30° to -11°), and -8±5° (range, -28° to -6°), respectively. Among four principal axes, the volar cortical and medial cortical axes were nearly collinear with both of relatively fixed carpal axes. The four principal axes showed angular differences between 2° and 8° with each other. There was no significant difference between men and women for all measurements.
The axial CT sections can be used to describe the various angulations between the normal wrist axes such as the sigmoid notch and scapholunate joint rotation angles. Despite slight differences among the four principal axes, the volar cortical and medial cortical axes are more consistent with the relatively fixed carpal axes.
本研究旨在确定轴向 CT 扫描中桡骨远端和腕骨的最准确背侧-掌侧主轴线，并建立这些轴线之间角度测量的正常参考值。
在 2019 年 12 月至 2021 年 12 月期间，回顾性分析了共 42 名个体（25 名男性，17 名女性；平均年龄：31±8.4 岁；年龄范围 18 岁至 45 岁）的正常轴向 CT 腕关节图像。在轴向 CT 图像上共识别出 8 个轴线：4 个桡骨远端轴线（掌侧皮质、内侧皮质、中央和乙状切迹轴线）和 4 个腕骨轴线（舟月、月三角、头状钩和舟月骨间）。参照 4 个主轴线（掌侧皮质、内侧皮质、中央和舟月骨间轴线）测量了 22 个角度参数。
相对于 4 个主轴线，乙状切迹的平均旋转（倾斜）角度分别为 8±5°（范围，-2°至 18°）、6±5°（范围，-2°至 13°）、1±5°（范围，-8°至 14°）和 4±4°（范围，-3°至 15°）。舟月骨的平均旋转角度分别为-13±5°（范围，-27°至-6°）、-15±6°（范围，-29°至-8°）、-21±5°（范围，-30°至-11°）和-8±5°（范围，-28°至-6°）。在 4 个主轴线中，掌侧皮质和内侧皮质轴线与相对固定的腕骨轴线几乎成一直线。4 个主轴线之间的角度差异在 2°至 8°之间。所有测量值在男性和女性之间均无显著差异。
轴向 CT 扫描可用于描述正常腕关节各轴线之间的各种角度，如乙状切迹和舟月关节的旋转角度。尽管 4 个主轴线之间存在细微差异，但掌侧皮质和内侧皮质轴线与相对固定的腕骨轴线更为一致。
