Abstract
Introduction
The purpose of this study was to describe the anatomy of the intramedullary canal of the radial neck for stem design of radial head prostheses.
Methods
Radial neck measurement was performed from the proximal edge of the radial tuberosity to the distal border of the articular surface on 40 macerated proximal radii using X-rays and Optosil imprints of the intramedullary canal. Radial neck to shaft angle was measured under image intensification.
Results
The neck length was 13.3 mm (range 8.0–20.0 mm) measured on X-rays and 13.5 mm (range 9.9–18.8 mm) on Optosil imprints. Concerning the neck’s intramedullary canal we obtained a minimum diameter of 9.7 mm (range 6.3–16.4 mm) on X-ray. Corresponding Optosil imprints had a mean diameter of 11.6 mm (range 6.6–18.6 mm) at their proximal end, 10.5 mm (range 5.5–16.3 mm) in the middle and a minimum of 9.8 mm (range 6.0–16.9 mm) at the distal end. Differences between left and right sides were not significant between X-ray and Optosil imprints, nor between left X-ray and right imprints and vice versa at a P-level of 0.001. Radial neck to shaft angle was 167.8° (range 160.5–178°) measured under image intensification at a rotation angle of 58.6° (range 50–70°) supination.
Conclusion
Geometry of the radial neck’s intramedullary canal has been described for stem design. The minimum diameter was seen at the distal end, just proximal to the radial tuberosity. A forearm rotation of 58.6° to full supination should be considered during implantation of monopolar prostheses. The wide variety of lengths and diameters complicates standard prosthetic design, but ipsilateral and contralateral X-rays can be useful for preoperative stem size calculation.
Similar content being viewed by others
References
Beredjiklian PK, Nalbantoglu U, Potter HG, Hotchkiss RN (1998) Prosthetic radial head components and proximal radial morphology: a mismatch. J Shoulder Elbow Surg 8:471–475
Captier G, Canovas F, Mercier N, Thomas E, Bonnel F (2002) Biometry of the radial head: biomechanical implications in pronation and supination. Surg Radiol Anat 24(5): 295–301 (Epub 2002 Nov 1)
Gupta GG, Moore-Jansen PH, Lucas GL (1992) Differences in radial head dimensions based on gender, race, age and side. Orthop Trans 16:342
Herbertsson P, Josefsson PO, Hasserius R, Besjakov J, Nyqvist F, Karlsson MK (2004) Fractures of the radial head treated with radial head excision. J Bone Joint Surg 86-A(9):1925–1930
Ikeda M, Yamashina Y, Kamimoto M, Oka Y (2003) Open reduction and internal fixation of comminuted fractures of the radial head using low-profile mini-plates. J Bone Joint Surg (B) 84-B:1040–1044
Ikeda M, Sugiyama K, Kang C, Takagaki T, Oka Y (2005) Comminuted fractures of the radial head. Comparison of resection and internal fixation. J Bone Joint Surg (A) 87(1)-A:76–84
King GJ, Zarzour ZD, Patterson SD, Johnson JA (2001) An anthropometric study of the radial head: implications in the design of a prosthesis. J Arthroplasty 16(1):112–116
Koslowsky TC, Germund I, Beyer F, Mader K, Krieglstein CF, Koebke J (2007) Morphometric parameters of the radial head: an anatomical study. Surg Radiol Anat 29(3):225–230
Mason MI (1954) Some observations on fractures of the head of the radius with a review of 100 cases. Br J Surg 42:123–132
Popovic N, Djekic J, Lemaire R, Gillet P (2005) A comparative study between proximal radial morphology and the floating radial head prosthesis. J Shoulder Elbow Surg 14(4):433–440
Ring D, Quintero J, Jupiter JB (2002) Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg (Am) 84-A:1811–1815
Roidis N, Stevanovic M, Martirosian A, Abbott DD, McPherson EJ, Itamura JM (2003) A radiographic study of proximal radius anatomy with implications in radial head replacement. J Shoulder Elbow Surg 12(4):380–384
Sanchez-Sotelo J, Romanillos O, Garay EG (2000) Results of acute excision of the radial head in elbow radial head fracture-dislocation. J Orthop Trauma 14(5):354–358
Swieszkowski W, Skalski K, Pomianowski S, Kedzior K (2001) The anatomic features of the radial head and their implication for prosthesis design. Clin Biomech (Bristol Avon) 16(10):880–887
Van Glabbeck F, Van Riet R, Verstreken J (2001) Current concepts in the treatment of radial head fractures in adults: a clinical and biomechanical approach. Acta Orthop Belg 67(5):430–441
Van Riet RP, Van Glabbeek F, Neale PG, Bimmel R, Bortier H, Morrey BF, O’Driscoll SW, An KN (2004) Anatomical considerations of the radius. Clin Anat 17(7):564–569
Van Riet RP, Van Glabbeek F, Neale PG, Bortier H, An KN, O’Driscoll SW (2003) The noncircular shape of the radial head. J Hand Surg (Am) 28(6):972–978
Weiss A-PC, Hastings H II (1992) The anatomy of the proximal radioulnar joint. J of Shoulder and Elbow Surg 1:193–199
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Koslowsky, T.C., Beyer, F., Germund, I. et al. Morphometric parameters of the radial neck: an anatomical study. Surg Radiol Anat 29, 279–284 (2007). https://doi.org/10.1007/s00276-007-0206-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-007-0206-4