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Published in: Surgical and Radiologic Anatomy 10/2014

01-12-2014 | Original Article

Proximal ulna morphometry: which are the “true” anatomical preshaped olecranon plates?

Authors: Trifon Totlis, Nikolaos Anastasopoulos, Stylianos Apostolidis, George Paraskevas, Ioannis Terzidis, Konstantinos Natsis

Published in: Surgical and Radiologic Anatomy | Issue 10/2014

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Abstract

Purpose

To define the optimum design of the anatomical preshaped olecranon plate.

Methods

The geometry of the proximal ulna was studied in 200 paired Caucasian ulnae, using a digital caliper and goniometer. Gender and side differences were analyzed. Results were compared with the corresponding geometrical parameters of three olecranon plates with different contour. All three plates were placed on the dorsal surface of a “model” ulna, i.e., a right dried ulna having osteometric parameters similar to the averages of our sample, and plate-to-bone fit was examined in two planes.

Results

The proximal ulna had an 8.48° (2.1°–15.7°) mean varus angulation and an 8.49° (1.70°–14.10°) mean anterior angulation, located on average 8.19 cm (5.68–11.66 cm) and 8.63 cm (5.28–11.92 cm) distal to the bone’s most proximal point, respectively. The mean olecranon angle was 110.34° (98.70°–125.80°) and the olecranon length was 1.58 cm on average (1.20–2.12 cm). Only the plate having both varus and anterior angulation presented a good plate-to-bone fit in both planes.

Conclusions

A “true” anatomical preshaped olecranon plate should have both varus and anterior angulation close to the average angulations of the normal ulna and located in a certain distance from its proximal edge. The olecranon part of the plate should primarily not exceed the olecranon length and secondarily be close to the average olecranon angle. We believe that such a plate may facilitate intraoperative restoration of the proximal ulna complex anatomy, when dealing with comminuted or Monteggia fractures, thus leading to better postoperative results.
Literature
1.
go back to reference Anderson ML, Larson N, Merten SM, Steinmann SP (2007) Congruent elbow plate fixation of olecranon fractures. J Orthop Trauma 21:386–393PubMedCrossRef Anderson ML, Larson N, Merten SM, Steinmann SP (2007) Congruent elbow plate fixation of olecranon fractures. J Orthop Trauma 21:386–393PubMedCrossRef
2.
go back to reference Brownhill JR, Mozzon JB, Ferreira LM, Johnson JA, King GJW (2009) Morphologic analysis of the proximal ulna with special interest in elbow implant sizing and alignment. J Shoulder Elbow Surg 18:27–32PubMedCrossRef Brownhill JR, Mozzon JB, Ferreira LM, Johnson JA, King GJW (2009) Morphologic analysis of the proximal ulna with special interest in elbow implant sizing and alignment. J Shoulder Elbow Surg 18:27–32PubMedCrossRef
3.
go back to reference Buijze G, Kloen P (2009) Clinical evaluation of locking compression plate fixation for comminuted olecranon fractures. J Bone Joint Surg Am 91:2416–2420PubMedCrossRef Buijze G, Kloen P (2009) Clinical evaluation of locking compression plate fixation for comminuted olecranon fractures. J Bone Joint Surg Am 91:2416–2420PubMedCrossRef
4.
go back to reference Cottias P, Camara KB, Clavert P, Kahn J, Livernaux PA (2010) Digastric olecranon osteotomy: feasibility study of a new approach to the elbow. Surg Radiol Anat 32:485–489PubMedCrossRef Cottias P, Camara KB, Clavert P, Kahn J, Livernaux PA (2010) Digastric olecranon osteotomy: feasibility study of a new approach to the elbow. Surg Radiol Anat 32:485–489PubMedCrossRef
5.
go back to reference Dakoure PWH, Ndiaye A, Sane AD, Niane MM, Seye SIL, Dia A (2007) Posterior surgical approaches to the elbow: a simple method of comparison of the articular exposure. Surg Radiol Anat 29:671–674PubMedCrossRef Dakoure PWH, Ndiaye A, Sane AD, Niane MM, Seye SIL, Dia A (2007) Posterior surgical approaches to the elbow: a simple method of comparison of the articular exposure. Surg Radiol Anat 29:671–674PubMedCrossRef
6.
go back to reference Erturer RE, Sever C, Sonmez MM, Ozcelik IB, Akman S, Ozturk I (2011) Results of open reduction and plate osteosynthesis in comminuted fracture of the olecranon. J Shoulder Elbow Surg 20:449–454PubMedCrossRef Erturer RE, Sever C, Sonmez MM, Ozcelik IB, Akman S, Ozturk I (2011) Results of open reduction and plate osteosynthesis in comminuted fracture of the olecranon. J Shoulder Elbow Surg 20:449–454PubMedCrossRef
7.
go back to reference Goldberg SH, Omid R, Nassr AN, Beck R, Cohen MS (2007) Osseous anatomy of the distal humerus and proximal ulna: implications for total elbow arthroplasty. J Shoulder Elbow Surg 16:S39–S46PubMedCrossRef Goldberg SH, Omid R, Nassr AN, Beck R, Cohen MS (2007) Osseous anatomy of the distal humerus and proximal ulna: implications for total elbow arthroplasty. J Shoulder Elbow Surg 16:S39–S46PubMedCrossRef
8.
go back to reference Grechening W, Clement H, Pichler W, Tesch NP, Windisch G (2007) The influence of lateral and anterior angulation of the proximal ulna on the treatment of a Monteggia fracture: an anatomical cadaver study. J Bone Joint Surg Br 89-B:836–838CrossRef Grechening W, Clement H, Pichler W, Tesch NP, Windisch G (2007) The influence of lateral and anterior angulation of the proximal ulna on the treatment of a Monteggia fracture: an anatomical cadaver study. J Bone Joint Surg Br 89-B:836–838CrossRef
9.
go back to reference Kozin SH, Berglung LJ, Cooney WP, Morrey BF, An K-N (1996) Biomechanical analysis of tension band fixation for olecranon fracture treatment. J Shoulder Elbow Surg 5:442–448PubMedCrossRef Kozin SH, Berglung LJ, Cooney WP, Morrey BF, An K-N (1996) Biomechanical analysis of tension band fixation for olecranon fracture treatment. J Shoulder Elbow Surg 5:442–448PubMedCrossRef
11.
go back to reference Kieffer EM, Bouchaid J, Bierry G, Clavert P (2013) CT arthrography and anatomical correlation of the bare area of the ulnar trochlear fossa: a risk of misdiagnosis of cartilage ulcerations. Surg Radiol Anat. doi:10.1007/s00276-013-1200-7 PubMed Kieffer EM, Bouchaid J, Bierry G, Clavert P (2013) CT arthrography and anatomical correlation of the bare area of the ulnar trochlear fossa: a risk of misdiagnosis of cartilage ulcerations. Surg Radiol Anat. doi:10.​1007/​s00276-013-1200-7 PubMed
12.
go back to reference Puchwein P, Schildhauer TA, Schöffmann S, Heidari N, Windisch G, Pichler W (2012) Three-dimensional morphometry of the proximal ulna: a comparison to currently used anatomically preshaped ulna plates. J Shoulder Elbow Surg 21:1018–1023PubMedCrossRef Puchwein P, Schildhauer TA, Schöffmann S, Heidari N, Windisch G, Pichler W (2012) Three-dimensional morphometry of the proximal ulna: a comparison to currently used anatomically preshaped ulna plates. J Shoulder Elbow Surg 21:1018–1023PubMedCrossRef
13.
go back to reference Quintero J, Varecka T (2007) Olecranon, radial head, and complex elbow injuries. In: Ruedi TP, Buckley R, Moran C (ed) AO principles of fracture management, vol 2, 2nd edn. Thieme Medical Publishers, New York, pp 628–633 Quintero J, Varecka T (2007) Olecranon, radial head, and complex elbow injuries. In: Ruedi TP, Buckley R, Moran C (ed) AO principles of fracture management, vol 2, 2nd edn. Thieme Medical Publishers, New York, pp 628–633
14.
go back to reference Rouleau DM, Faber KJ, Athwal GS (2010) The proximal ulna dorsal angulation: a radiographic study. J Shoulder Elbow Surg 19:26–30PubMedCrossRef Rouleau DM, Faber KJ, Athwal GS (2010) The proximal ulna dorsal angulation: a radiographic study. J Shoulder Elbow Surg 19:26–30PubMedCrossRef
15.
go back to reference Rouleau DM, Canet F, Chapleau J, Petit Y, Sandman E, Faber KJ et al (2012) The influence of proximal ulnar morphology on elbow range of motion. J Shoulder Elbow Surg 21:384–388PubMedCrossRef Rouleau DM, Canet F, Chapleau J, Petit Y, Sandman E, Faber KJ et al (2012) The influence of proximal ulnar morphology on elbow range of motion. J Shoulder Elbow Surg 21:384–388PubMedCrossRef
16.
go back to reference Wang AA, Mara M, Hutchinson DT (2003) The proximal ulna: an anatomic study with relevance to olecranon osteotomy and fracture fixation. J Shoulder Elbow Surg 12:293–296PubMedCrossRef Wang AA, Mara M, Hutchinson DT (2003) The proximal ulna: an anatomic study with relevance to olecranon osteotomy and fracture fixation. J Shoulder Elbow Surg 12:293–296PubMedCrossRef
17.
go back to reference Windisch G, Clement H, Grechenig W, Tesch NP, Pichler W (2007) A morphometrical study of the medullary cavity of the ulna referred to intramedullary nailing. Surg Radiol Anat 29:47–53PubMedCrossRef Windisch G, Clement H, Grechenig W, Tesch NP, Pichler W (2007) A morphometrical study of the medullary cavity of the ulna referred to intramedullary nailing. Surg Radiol Anat 29:47–53PubMedCrossRef
18.
go back to reference Windisch G, Clement H, Grechenig W, Tesch NP, Pichler W (2007) The anatomy of the proximal ulna. J Shoulder Elbow Surg 16:661–666PubMedCrossRef Windisch G, Clement H, Grechenig W, Tesch NP, Pichler W (2007) The anatomy of the proximal ulna. J Shoulder Elbow Surg 16:661–666PubMedCrossRef
Metadata
Title
Proximal ulna morphometry: which are the “true” anatomical preshaped olecranon plates?
Authors
Trifon Totlis
Nikolaos Anastasopoulos
Stylianos Apostolidis
George Paraskevas
Ioannis Terzidis
Konstantinos Natsis
Publication date
01-12-2014
Publisher
Springer Paris
Published in
Surgical and Radiologic Anatomy / Issue 10/2014
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-014-1287-5

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