Surgical and Radiologic Anatomy

, Volume 41, Issue 4, pp 423–429 | Cite as

The relationship between the morphological axis and the kinematic axis of the proximal radius

  • Satoshi OkiEmail author
  • Naoto Inaba
  • Noboru Matsumura
  • Takuji Iwamoto
  • Yoshitake Yamada
  • Masahiro Jinzaki
  • Takeo Nagura
Original Article



Surgical procedures for impaired forearm rotation such as for chronic radial head dislocation remain controversial. We hypothesized that the morphological axis of the proximal radius is important for stable forearm rotation, and we aimed to clarify the relationship between the morphological axis and the kinematic axis of the proximal radius using four-dimensional computed tomography (4DCT).


Ten healthy volunteers were enrolled. Four-dimensional CT of the dominant forearm during supination and pronation was obtained. The rotation axis of forearm rotation was calculated from all frames during supination and pronation. The principle axis of inertia, which represents the most stable rotation axis of a rigid body, was calculated for the proximal radius by extending its surface data incrementally by 1% from the proximal end. The angle between the kinematic rotation axis and the morphological rotation axis of each length was calculated.


The rotation axis of the forearm was positioned on the radial head 0.0 mm radial and 0.4 mm posterior to the center of the radial head proximally and 2.0 mm radial and 1.2 mm volar to the fovea of the ulnar head distally. The principle axis at 15.9% of the length of the proximal radius coincided with the forearm rotation axis (kinematic axis). Individual differences were very small (SD 1.4%).


Forearm rotation was based on the axis at 16% of the length of the proximal radius. This portion should be aligned in cases of severe morphological deformity of the radial head that cause “rattling motion” of the radial head after reduction procedures.


Computed tomography Radius Rotation axis 4DCT 


Author contributions

SO: Data analysis, manuscript writing and management. NI, NM, TI and TN: Protocol development. MJ and YY: Protocol of 4DCT data acquisition.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OrthopedicsKeio University School of MedicineTokyoJapan
  2. 2.Department of OrthopedicsSaiseikai Utsunomiya HospitalUtsunomiyaJapan
  3. 3.Department of RadiologyKeio University School of MedicineTokyoJapan
  4. 4.Department of BiomechanicsKeio University School of MedicineTokyoJapan

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