Skip to main content

Advertisement

SpringerLink
Log in

Morphometric analysis of the lateral column of the distal humerus with an interest on radio-capitellar arthroplasty design. A computed tomography anatomical study on 50 elbows

  • Original Article
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

To perform a morphometric analysis of the distal humerus lateral column medullary canal (LCMC).

Methods

Fifty computed tomography(CTs) from 24 males and 26 females were examined. Two observers measured: (1) the capitellum sagittal (RS) and axial (RT) radii of curvature; (2) the sagittal(Sd) and coronal(Cd) diameters of the LCMC in 5 different disto-proximal sites spaced 4 mm apart; (3) the capitellum and LCMC axis offsets on the sagittal (capSO,axSO) and coronal (capCO,axCO) planes; (4) the sagittal (Si) and coronal (Ci) inclination of the LCMC axis.

Results

The mean RS and RT were 1.07 cm (SD, 0.11) and 1.30 cm (SD, 0.11), respectively. The mean Sd and Cd values were 1.17 cm (SD, 0.17) and 1.58 cm (SD, 0.24), respectively, with a disto-proximal decrease on both planes. The capSO, capCO, axSO and axCO mean values were 0.76 (SD, 0.21), 1.60 (SD, 0.27), − 0.16 (SD, 0.30) and 0.79 cm (SD, 0.30), respectively. Si and Ci were 70° and 72°, respectively. A strong correlation (r = 0.78) was found between RS and RT and between adjacent levels of Sd and Cd. AxSO and axCO yielded a strong inverse correlation. Male patients showed higher values than female ones in all variables (p < 0.03). The intra-class correlation coefficient (ICC) was always > 0.9.

Conclusion

The dimensions of the LCMC decrease disto-proximally, with the coronal diameters being greater than the sagittal diameters, resembling a portion of an elliptic torus with an antero-medial concavity. The articular surface of the humeral capitellum is non-spherical, with two strongly correlated radii of curvature. The results of this study may be relevant to the stem design of radiocapitellar arthroplasty.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Brownhill JR, King GJ, Johnson JA. Morphologic analysis of the distal humerus with special interest in elbow implant sizing and alignment. J Shoulder Elbow Surg. 2007;16(3 Suppl):S126–32. https://doi.org/10.1016/j.jse.2006.01.018.

    Article  PubMed  Google Scholar 

  2. Desai SJ, Deluce S, Johnson JA, Ferreira LM, Leclerc AE, Athwal GS, King GJ. An anthropometric study of the distal humerus. J Shoulder Elbow Surg. 2014;23(4):463–9. https://doi.org/10.1016/j.jse.2013.11.026 (Epub 2014 Feb 20 PMID: 24560468).

    Article  PubMed  Google Scholar 

  3. Giannicola G, Sacchetti FM, Polimanti D, Bullitta G, Scacchi M, Sedati P. Elbow joint. In: Tubbs RS, Shoja MM, Loukas M, editors. Bergman’s comprehensive encyclopedia of human anatomic variations. Hoboken: John Wiley & Sons; 2016. p. 130–57.

    Chapter  Google Scholar 

  4. Giannicola G, Scacchi M, Sedati P, Gumina S. Anatomical variations of the trochlear notch angle: MRI analysis of 78 elbows. Musculoskelet Surg. 2016;100(Suppl.1):89–95. https://doi.org/10.1007/s12306-016-0407-2.

    Article  CAS  PubMed  Google Scholar 

  5. Giannicola G, Sedati P, Polimanti D, Cinotti G, Bullitta G. Contribution of cartilage to size and shape of radial head circumference: magnetic resonance imaging analysis of 78 elbows. J Shoulder Elbow Surg. 2016;25(1):120–6. https://doi.org/10.1016/j.jse.2015.07.003.

    Article  PubMed  Google Scholar 

  6. Giannicola G, Spinello P, Scacchi M, Gumina S. Cartilage thickness of distal humerus and its relationships with bone dimensions: magnetic resonance imaging bilateral study in healthy elbows. J Shoulder Elbow Surg. 2017;26(5):e128–36. https://doi.org/10.1016/j.jse.2016.10.012.

    Article  PubMed  Google Scholar 

  7. Sabo MT, McDonald CP, Ng J, Ferreira LM, Johnson JA, King GJ. A morphological analysis of the humeral capitellum with an interest in prosthesis design. J Shoulder Elbow Surg. 2011;20(6):880–4. https://doi.org/10.1016/j.jse.2011.01.007.

    Article  PubMed  Google Scholar 

  8. Shiba R, Sorbie C, Siu DW, Bryant JT, Cooke TD, Wevers HW. Geometry of the humeroulnar joint. J Orthop Res. 1988;6(6):897–906. https://doi.org/10.1002/jor.1100060614.

    Article  CAS  PubMed  Google Scholar 

  9. Wevers HW, Broekhoven LH, Sorbie C. Resurfacing elbow prosthesis: shape and sizing of the humeral component. J Biomed Eng. 1985;7:241–6.

    Article  CAS  PubMed  Google Scholar 

  10. Giannicola G, Calella P, Bigazzi P, Mantovani A, Spinello P, Cinotti G. Midterm results of radiocapitellar arthroplasty of the elbow: a multicentre prospective study on two different implants. Bone Jt J. 2019;101(11):1362–9. https://doi.org/10.1302/0301-620X.101B11.BJJ-2019-0155.R2.

    Article  Google Scholar 

  11. Watkins CEL, Elson DW, Harrison JWK, Pooley J. Long-term results of the lateral resurfacing elbow arthroplasty. Bone Jt J. 2018;100(3):338–45. https://doi.org/10.1302/0301-620X.100B3.BJJ-2017-0865.R1.

    Article  Google Scholar 

  12. King GJ, Zarzour ZD, Patterson SD, Jonson JA. An anthropometric study of the radial head: implications in the design of a prosthesis. J Arthroplasty. 2001;16:112–6. https://doi.org/10.1054/arth.2001.16499.

    Article  CAS  PubMed  Google Scholar 

  13. Van Riet RP, Van Glabbeek F, Neale PG, Bortier H, An KN, O’Driscoll SW. The noncircular shape of the radial head. J Hand Surg Am. 2003;28:972–8. https://doi.org/10.1016/s0363-5023(03)00426-x.

    Article  PubMed  Google Scholar 

  14. Giannicola G, Sedati P, Cinotti G, Bullitta G, Polimanti D. The ulnar greater sigmoid notch “coverage angle”: bone and cartilage contribution. Magnetic resonance imaging anatomic study on 78 elbows. J Shoulder Elbow Surg. 2015;24(12):1934–8. https://doi.org/10.1016/j.jse.2015.06.006.

    Article  PubMed  Google Scholar 

  15. Heijink A, Morrey BF, Eygendaal D. Radiocapitellar prosthetic arthroplasty: a report of 6 cases and review of the literature. J Shoulder Elbow Surg. 2014;23(6):843–9. https://doi.org/10.1016/j.jse.2014.01.042.

    Article  PubMed  Google Scholar 

  16. Pooley J. Unicompartmental elbow replacement: development of a lateral replacement elbow (LRE) arthroplasty. Tech Shoulder Elbow Surg. 2007;8:204–12.

    Article  Google Scholar 

  17. Tomaino M. The emerging role for UNI-elbow arthroplasty. Am J Orthop. 2008;37(Suppl.8):26–8.

    PubMed  Google Scholar 

  18. Bigazzi P, Biondi M, Ceruso M. Radiocapitellar prosthetic arthroplasty in traumatic and post-traumatic complex lesions of the elbow. Eur J Orthop Surg Traumatol. 2016;26(8):851–8. https://doi.org/10.1007/s00590-016-1837-0.

    Article  PubMed  Google Scholar 

  19. Giannicola G, Angeloni R, Mantovani A, Rebuzzi E, Merolla G, Greco A, et al. Open debridement and radiocapitellar replacement in primary and post-traumatic arthritis of the elbow: a multicenter study. J Shoulder Elbow Surg. 2012;21(4):456–63. https://doi.org/10.1016/j.jse.2011.08.071.

    Article  PubMed  Google Scholar 

  20. Kachooei AR, Heesakkers NAM, Heijink A, The B, Eygendaal D. Radiocapitellar prosthetic arthroplasty: short-term to midterm results of 19 elbows. J Shoulder Elbow Surg. 2018;27(4):726–32. https://doi.org/10.1016/j.jse.2017.12.013.

    Article  PubMed  Google Scholar 

  21. Pierrepont JW, Marel E, Baré JV, Walter LR, Stambouzou CZ, Solomon MI, McMahon S, Shimmin AJ. Variation in femoral anteversion in patients requiring total hip replacement. Hip Int. 2020;30(3):281–7. https://doi.org/10.1177/1120700019848088.

    Article  PubMed  Google Scholar 

  22. Toogood PA, Skalak A, Cooperman DR. Proximal femoral anatomy in the normal human population. Clin Orthop Relat Res. 2009;467(4):876–85. https://doi.org/10.1007/s11999-008-0473-3.

    Article  PubMed  Google Scholar 

  23. Goldberg RW, Williamson DF, Hoyen HA, Liu RW. Humeral version and neck-shaft angle correlated with demographic parameters in a study of 1104 cadaveric humeri. J Shoulder Elbow Surg. 2020;29(6):1236–41. https://doi.org/10.1016/j.jse.2019.10.009.

    Article  PubMed  Google Scholar 

  24. Pearl ML. Proximal humeral anatomy in shoulder arthroplasty: implications for prosthetic design and surgical technique. J Shoulder Elbow Surg. 2005;14(1 Suppl S):99S-104S. https://doi.org/10.1016/j.jse.2004.09.025.

    Article  PubMed  Google Scholar 

  25. Innmann MM, Spier K, Streit MR, Aldinger PR, Bruckner T, Gotterbarm T, Merle C. Comparative analysis of the reconstruction of individual hip anatomy using 3 different cementless stem designs in patients with primary hip osteoarthritis. J Arthroplasty. 2018;33(4):1126–32. https://doi.org/10.1016/j.arth.2017.11.026.

    Article  PubMed  Google Scholar 

  26. Piriou P, Bugyan H, Casalonga D, Lizée E, Trojani C, Versier G. Can hip anatomy be reconstructed with femoral components having only one neck morphology? A study on 466 hips. J Arthroplasty. 2013;28(7):1185–91. https://doi.org/10.1016/j.arth.2012.08.023.

    Article  PubMed  Google Scholar 

  27. Schoch B, Werthel JD, Schleck C, Sperling JW, Cofield RH. Does an increase in modularity improve the outcomes of total shoulder replacement? Comparison across design generations. Int Orthop. 2015;39(10):2053–60. https://doi.org/10.1007/s00264-015-2874-8.

    Article  PubMed  Google Scholar 

Download references

Funding

None of the authors, their immediate family, and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article.

Author information

Authors and Affiliations

  1. Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, “Sapienza” University of Rome -Policlinico Umberto I, Rome, Italy

    Giuseppe Giannicola, Matteo Cantore, Sebastien Prigent & Gianluca Cinotti

  2. Azienda Ospedaliera San Camillo Forlanini, Department of Orthopedics and Traumatology, San Camillo-Forlanini Hospital, Circonvallazione Gianicolense 87, 00100, Rome, Italy

    Pasquale Sessa

Authors
  1. Giuseppe Giannicola
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matteo Cantore
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sebastien Prigent
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gianluca Cinotti
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pasquale Sessa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Giuseppe Giannicola.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest to declare.

Ethical approval

Informed consent, in accordance with the Declaration of Helsinki, was obtained from all the participants. Due to the nature of the study and according to the current law of our country, no ethical committee approval was necessary.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Giannicola, G., Cantore, M., Prigent, S. et al. Morphometric analysis of the lateral column of the distal humerus with an interest on radio-capitellar arthroplasty design. A computed tomography anatomical study on 50 elbows. Eur J Trauma Emerg Surg 49, 143–153 (2023). https://doi.org/10.1007/s00068-022-02053-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-022-02053-3

Keywords

Search

Navigation