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Published in: Skeletal Radiology 9/2010

01-09-2010 | Scientific Article

Simple overlay device for determining radial head and neck height

Authors: Jun-Gyu Moon, Richard D. Southgate, James S. Fitzsimmons, Shawn W. O’Driscoll

Published in: Skeletal Radiology | Issue 9/2010

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Abstract

Background

The purpose of this study was to test the hypothesis that a simple overlay device can be used on radiographs to measure radial head and neck height.

Materials and methods

Thirty anteroposterior elbow radiographs from 30 patients with a clinical diagnosis of lateral epicondylitis were examined to measure radial head and neck height. Three methods using different points along the bicipital tuberosity as a landmark were used. Method 1 used the proximal end of the bicipital tuberosity, method 2 used the most prominent point of the bicipital tuberosity, and method 3 used a simple overlay device (SOD) template that was aligned with anatomic reference points. All measurements were performed three times by three observers to determine interobserver and intraobserver reliability.

Results

Intraclass correlation coefficients revealed higher interobserver and intraobserver correlations for the SOD template method than for the other two methods. The 95% limits of agreement between observers were markedly better (−1.8 mm to +1.0 mm) for the SOD template method than for the proximal point method (−3.8 mm to +3.4 mm) or the prominent point method (−5.9 mm to +4.9 mm).

Conclusions

We found that the SOD template method was reliable for assessing radial head and neck height. It had less variability than other methods, its 95% limit of agreement being less than 2 mm. This method could be helpful for assessing whether or not the insertion of a radial head prosthesis has resulted in over-lengthening of the radius.
Literature
1.
go back to reference Harrington IJ, Tountas AA. Replacement of the radial head in the treatment of unstable elbow fractures. Injury. 1981;12:405–12.CrossRefPubMed Harrington IJ, Tountas AA. Replacement of the radial head in the treatment of unstable elbow fractures. Injury. 1981;12:405–12.CrossRefPubMed
2.
go back to reference Moro JK, Werier J, MacDermid JC, Patterson SD, King GJ. Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. J Bone Joint Surg Am. 2001;83:1201–11.PubMed Moro JK, Werier J, MacDermid JC, Patterson SD, King GJ. Arthroplasty with a metal radial head for unreconstructible fractures of the radial head. J Bone Joint Surg Am. 2001;83:1201–11.PubMed
3.
go back to reference Birkedal JP, Deal DN, Ruch DS. Loss of flexion after radial head replacement. J Shoulder Elbow Surg. 2004;13:208–13.CrossRefPubMed Birkedal JP, Deal DN, Ruch DS. Loss of flexion after radial head replacement. J Shoulder Elbow Surg. 2004;13:208–13.CrossRefPubMed
4.
go back to reference Van Riet RP, Van Glabbeek F, Verborgt O, Gielen J. Capitellar erosion caused by a metal radial head prosthesis. A case report. J Bone Joint Surg Am. 2004;86:1061–4.PubMed Van Riet RP, Van Glabbeek F, Verborgt O, Gielen J. Capitellar erosion caused by a metal radial head prosthesis. A case report. J Bone Joint Surg Am. 2004;86:1061–4.PubMed
5.
go back to reference Shors HC, Gannon C, Miller MC, Schmidt CC, Baratz ME. Plain radiographs are inadequate to identify overlengthening with a radial head prosthesis. J Hand Surg [Am]. 2008;33:335–9.CrossRef Shors HC, Gannon C, Miller MC, Schmidt CC, Baratz ME. Plain radiographs are inadequate to identify overlengthening with a radial head prosthesis. J Hand Surg [Am]. 2008;33:335–9.CrossRef
6.
go back to reference Doornberg JN, Linzel DS, Zurakowski D, Ring D. Reference points for radial head prosthesis size. J Hand Surg [Am]. 2006;31:53–7.CrossRef Doornberg JN, Linzel DS, Zurakowski D, Ring D. Reference points for radial head prosthesis size. J Hand Surg [Am]. 2006;31:53–7.CrossRef
7.
go back to reference Grewal R, MacDermid JC, Faber KJ, Drosdowech DS, King GJ. Comminuted radial head fractures treated with a modular metallic radial head arthroplasty. Study of outcomes. J Bone Joint Surg Am. 2006;88:2192–200.CrossRefPubMed Grewal R, MacDermid JC, Faber KJ, Drosdowech DS, King GJ. Comminuted radial head fractures treated with a modular metallic radial head arthroplasty. Study of outcomes. J Bone Joint Surg Am. 2006;88:2192–200.CrossRefPubMed
8.
go back to reference Ring D, King G. Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability. Surgical technique. J Bone Joint Surg Am. 2008;90 Suppl 2 Pt 1:63–73..CrossRefPubMed Ring D, King G. Radial head arthroplasty with a modular metal spacer to treat acute traumatic elbow instability. Surgical technique. J Bone Joint Surg Am. 2008;90 Suppl 2 Pt 1:63–73..CrossRefPubMed
9.
go back to reference Van Riet RP, Van Glabbeek F, de Weerdt W, Oemar J, Bortier H. Validation of the lesser sigmoid notch of the ulna as a reference point for accurate placement of a prosthesis for the head of the radius: a cadaver study. J Bone Joint Surg Br. 2007;89:413–6.PubMed Van Riet RP, Van Glabbeek F, de Weerdt W, Oemar J, Bortier H. Validation of the lesser sigmoid notch of the ulna as a reference point for accurate placement of a prosthesis for the head of the radius: a cadaver study. J Bone Joint Surg Br. 2007;89:413–6.PubMed
10.
go back to reference Gallistel C. Brains as symbol processors: the case of insect navigation. In: Sternberg S, Scarborough D, editors. An invitation to cognitive science: methods, models, and conceptual issues, Vol. 4. 2nd ed. Cambridge: MIT Press; 1998. p. 1–51. Gallistel C. Brains as symbol processors: the case of insect navigation. In: Sternberg S, Scarborough D, editors. An invitation to cognitive science: methods, models, and conceptual issues, Vol. 4. 2nd ed. Cambridge: MIT Press; 1998. p. 1–51.
11.
go back to reference Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86:420–8.CrossRefPubMed Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86:420–8.CrossRefPubMed
12.
go back to reference Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10.PubMed Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10.PubMed
13.
go back to reference Van Glabbeek F, van Riet RP, Baumfeld JA, Neale PG, O'Driscoll SW, Morrey BF, et al. The kinematic importance of radial neck length in radial head replacement. Med Eng Phys. 2005;27:336–42.CrossRefPubMed Van Glabbeek F, van Riet RP, Baumfeld JA, Neale PG, O'Driscoll SW, Morrey BF, et al. The kinematic importance of radial neck length in radial head replacement. Med Eng Phys. 2005;27:336–42.CrossRefPubMed
14.
go back to reference Van Glabbeek F, Van Riet RP, Baumfeld JA, Neale PG, O'Driscoll SW, Morrey BF, et al. Detrimental effects of overstuffing or understuffing with a radial head replacement in the medial collateral-ligament deficient elbow. J Bone Joint Surg Am. 2004;86:2629–35.PubMed Van Glabbeek F, Van Riet RP, Baumfeld JA, Neale PG, O'Driscoll SW, Morrey BF, et al. Detrimental effects of overstuffing or understuffing with a radial head replacement in the medial collateral-ligament deficient elbow. J Bone Joint Surg Am. 2004;86:2629–35.PubMed
15.
go back to reference Rowland AS, Athwal GS, MacDermid JC, King GJ. Lateral ulnohumeral joint space widening is not diagnostic of radial head arthroplasty overstuffing. J Hand Surg [Am]. 2007;32:637–41.CrossRef Rowland AS, Athwal GS, MacDermid JC, King GJ. Lateral ulnohumeral joint space widening is not diagnostic of radial head arthroplasty overstuffing. J Hand Surg [Am]. 2007;32:637–41.CrossRef
16.
go back to reference Mazzocca AD, Cohen M, Berkson E, Nicholson G, Carofino BC, Arciero R, et al. The anatomy of the bicipital tuberosity and distal biceps tendon. J Shoulder Elbow Surg. 2007;16:122–7.CrossRefPubMed Mazzocca AD, Cohen M, Berkson E, Nicholson G, Carofino BC, Arciero R, et al. The anatomy of the bicipital tuberosity and distal biceps tendon. J Shoulder Elbow Surg. 2007;16:122–7.CrossRefPubMed
17.
go back to reference Koslowsky TC, Beyer F, Germund I, Mader K, Jergas M, Koebke J. Morphometric parameters of the radial neck: an anatomical study. Surg Radiol Anat. 2007;29:279–84.CrossRefPubMed Koslowsky TC, Beyer F, Germund I, Mader K, Jergas M, Koebke J. Morphometric parameters of the radial neck: an anatomical study. Surg Radiol Anat. 2007;29:279–84.CrossRefPubMed
18.
go back to reference Popovic N, Djekic J, Lemaire R, Gillet P. A comparative study between proximal radial morphology and the floating radial head prosthesis. J Shoulder Elbow Surg. 2005;14:433–40.CrossRefPubMed Popovic N, Djekic J, Lemaire R, Gillet P. A comparative study between proximal radial morphology and the floating radial head prosthesis. J Shoulder Elbow Surg. 2005;14:433–40.CrossRefPubMed
Metadata
Title
Simple overlay device for determining radial head and neck height
Authors
Jun-Gyu Moon
Richard D. Southgate
James S. Fitzsimmons
Shawn W. O’Driscoll
Publication date
01-09-2010
Publisher
Springer-Verlag
Published in
Skeletal Radiology / Issue 9/2010
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-010-0893-5

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