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桡骨远端月骨小关节掌侧皮质形态的三维形态计量学分析

Three-Dimensional Morphometric Analysis of the Volar Cortical Shape of the Lunate Facet of the Distal Radius.

作者信息

Eda Yusuke, Asai Reo, Kohyama Sho, Ikumi Akira, Totoki Yasukazu, Yoshii Yuichi

机构信息

Department of Orthopaedic Surgery, Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba 305-8576, Japan.

Department of Orthopedic Surgery, Tokyo Medical University Ibaraki Medical Center, Ami 300-0395, Japan.

出版信息

Diagnostics (Basel). 2024 Aug 18;14(16):1802. doi: 10.3390/diagnostics14161802.

Abstract

In cases of distal radius fractures, the fixation of the volar lunate facet fragment is crucial for preventing volar subluxation of the carpal bones. This study aims to clarify the sex differences in the volar morphology of the lunate facet of the distal radius and its relationship with the transverse diameter of the distal radius. Sixty-four CT scans of healthy wrists (30 males and 34 females) were evaluated. Three-dimensional (3D) images of the distal radius were reconstructed from the CT data. We defined reference point 1 as the starting point of the inclination toward the distal volar edge, reference point 2 as the volar edge of the joint on the bone axis, and reference point 3 as the volar edge of the distal radius lunate facet. From the 3D coordinates of reference points 1 to 3, the bone axis distance, volar-dorsal distance, radial-ulnar distance, 3D straight-line distance, and inclination angle were measured. The transverse diameter of the radius was measured, and its correlations with the parameters were evaluated. It was found that in males, compared to females, the transverse diameter of the radius is larger and the protrusion of the volar lunate facet is greater. This suggests that the inclination of the volar surface is steeper in males and that the volar locking plate may not fit properly with the volar cortical bone of the lunate facet, necessitating additional fixation.

摘要

在桡骨远端骨折病例中,掌侧月骨面骨折块的固定对于防止腕骨掌侧半脱位至关重要。本研究旨在阐明桡骨远端月骨面掌侧形态的性别差异及其与桡骨远端横径的关系。对64例健康腕部的CT扫描图像(30例男性和34例女性)进行了评估。从CT数据重建桡骨远端的三维(3D)图像。我们将参考点1定义为向掌侧远端边缘倾斜的起点,参考点2定义为骨轴上关节的掌侧边缘,参考点3定义为桡骨远端月骨面的掌侧边缘。根据参考点1至3的三维坐标,测量骨轴距离、掌背距离、桡尺距离、三维直线距离和倾斜角度。测量桡骨的横径,并评估其与各参数的相关性。结果发现,与女性相比,男性的桡骨横径更大,掌侧月骨面的突出更明显。这表明男性掌侧表面的倾斜度更陡,掌侧锁定钢板可能无法与月骨面的掌侧皮质骨良好贴合,因此需要额外固定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c85b/11353463/fdfaf51b93ce/diagnostics-14-01802-g001.jpg

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