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用于桡骨远端重建的骰骨:基于三维模型的解剖学研究

Cuboid Bone for Distal Radius Reconstruction: An Anatomical Study by 3D Models.

作者信息

Alvedro-Ruiz Pedro, Trapero-Ovejero Ana, Ferràs-Tarragó Joan, Pérez-García Alberto, Thione Alessandro

机构信息

Department of Plastic and Reconstructive Surgery, University and Polytechnic Hospital La Fe, Valencia, Spain.

Department of Orthopaedic Surgery, University and Polytechnic Hospital La Fe, Valencia, Spain.

出版信息

J Wrist Surg. 2024 Apr 15;14(4):342-349. doi: 10.1055/s-0044-1785499. eCollection 2025 Aug.

Abstract

Distal radius (DR) reconstruction due to high-energy trauma, degenerative processes, and oncologic resections can be a challenge when the articular surface is destroyed or resected. This study investigates the possibility of using the cuboid bone of the foot to replace the osteoarticular surface of DR.  We compared the three-dimensional (3D) morphology of the articular surface of three foot bones with that of the DR to analyze which one would be the most suitable to replace it.  3D bone models were created from a computed tomography (CT) scan database. The articular surfaces of calcaneus, cuboid bone, and lateral cuneiform bone were compared with that of the DR using the Hausdorff-Besicovitch morphometry analysis. Mean, maximum, and minimum differences were obtained and statistically analyzed.  The cuboid bone had a mean overall area difference with the DR of 0.72 mm (standard deviation [SD], 0.03 mm). The lateral cuneiform bone showed 0.89 mm (SD, 0.08 mm). The calcaneus presented 1.04 mm (SD, 0.06 mm). The differences and the variability of the articular surface were statistically lower in the cuboid bone.  The articular surface of the cuboid bone has many similarities to the articular surface of the DR and had the most similarities to the DR of the foot bones study. The cuboid bone could be considered as a replacement for the DR in cases where there is a need for osteoarticular replacement or reconstruction. Further investigations are warranted.  A vascularized transfer of the cuboid bone may be a suitable option to replace a DR given the anatomical similarities reported.

摘要

由于高能创伤、退行性病变和肿瘤切除导致的桡骨远端(DR)重建,在关节面遭到破坏或切除时可能是一项挑战。本研究探讨了使用足部骰骨替代DR骨关节面的可能性。

我们比较了三块足部骨骼的关节面与DR关节面的三维(3D)形态,以分析哪一块骨骼最适合替代它。

从计算机断层扫描(CT)扫描数据库创建3D骨骼模型。使用豪斯多夫-贝西科维奇形态测量分析,将跟骨、骰骨和外侧楔骨的关节面与DR的关节面进行比较。获得平均、最大和最小差异并进行统计分析。

骰骨与DR的平均总面积差异为0.72毫米(标准差[SD],0.03毫米)。外侧楔骨为0.89毫米(SD,0.08毫米)。跟骨为1.04毫米(SD,0.06毫米)。骰骨关节面的差异和变异性在统计学上更低。

骰骨的关节面与DR的关节面有许多相似之处,在足部骨骼研究中与DR的相似性最高。在需要进行骨关节置换或重建的情况下,骰骨可被视为DR的替代物。有必要进行进一步研究。

鉴于所报道的解剖学相似性,带血管蒂的骰骨转移可能是替代DR的合适选择。

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