Proksimal ulnanın morfometrik analizi: Anatomik bir çalışma
Abstract
Amaç: Yüz yedi kuru ulnanın detaylı analizi ile proksimal ulna morfometrisinin araştırılması ve olası klinik öneminin ortaya konulması.
Gereç ve Yöntem: Toplam 107 (52 sol, 55 sağ) kuru ulna değerlendirildi. Ulna uzunlukları, olecranon ve troklear ölçümleri yapıldı. Tüm ölçümler 0,01 mm hassasiyetli dijital kumpas ile gerçekleştirildi.
Bulgular: Ortalama ulna uzunluğu ve troklear çentik hariç ulna uzunluğu sırasıyla 261,17±43,07 mm ve 232,37±43,17 mm idi. Ortalama posterior olecranon yüksekliği, orta olecranon yüksekliği ve anterior olecranon yüksekliği sırasıyla 24,05±2,36 mm, 17,80±1,70 mm ve 35,15±3,60 mm olarak elde edildi. Ortalama olekranon genişliği 23,20±2,79 mm idi. Ayrıca, ortalama troklear çentik genişliği, radyal troklear çentik genişliği ve ulnar troklear çentik genişliği sırasıyla 22,79±2,81 mm, 24,80±2,69 mm ve 30,14±3,05 mm idi. Ortalama radial troklear yükseklik 13,45±2,26 mm, ulnar troklear yükseklik ise 14,69±2,23 mm idi. Son olarak, ortalama radyal çentik yüksekliği, radyal çentik genişliği, radyal çentik-olecranon posterior ve radyal çentik-olecranon anterior sırasıyla 11,15±1,94 mm, 18,02±2,60 mm, 12,91±2.92 mm ve 30,94±4,62 mm olarak ölçüldü.
Sonuçlar: Çalışmamızın bulguları proksimal ulna kırıklarının tedavisinde dorsal plakların, intramedüller vida fiksasyonunun ve anatomik olarak önceden şekillendirilmiş plakların uygulanmasında yararlı olabilir.
Keywords
References
- Fornalski S, Gupta R, Lee TQ. Anatomy and biomechanics of the elbow joint. Tech Hand Up Extrem Surg 2003;7:168-78.
- Wang D, Li J, Xu G, Zhang H, Xu C, Zhang W, Li H, Gan X, Xiong Y, Zhang L, Li L, Tang P. Morphometric feature description of the proximal ulna based on quantitative measurement: a key consideration for implant design. Surg Radiol Anat 2023;45(2):215-24.
- Masood QM, Qulaghassi M, Grewal U, Bawale R, Kammela M, Singh B. Proximal ulna fractures in adults: A review of diagnosis and management. J Orthop Trauma 2021;20:101481.
- Duckworth AD, Carter TH, Chen MJ, Gardner MJ, Watts AC. Olecranon fractures: current treatment concepts. Bone Joint J 2023;105:112-23.
- Siebenlist S, Buchholz A, Braun KF. Fractures of the proximal ulna: current concepts in surgical management. EFORT Open Rev 2019;4(1):1-9.
- Beşer CG, Demiryürek D, Özsoy H, Erçakmak B, Hayran M, Kızılay O, Özsoy A. Redefining the proximal ulna anatomy. Surg Radiol Anat 2014;36(10):1023-31.
- Erdem H. Surgical importance of radiographically aided morphometry of the proximal ulna. Int J Morphol 2020;38(2):299-304.
- Rouleau DM, Faber KJ, Athwal GS. The proximal ulna dorsal angulation: a radiographic study. J Shoulder Elbow Surg 2010;19(1):26-30.
- Morrey BF, An KN. Stability of the elbow: osseous constraints. J Shoulder Elbow Surg 2005;14(1 Suppl S):174S-8S.
- Melamed E, Danna N, Debkowska M, Karia R, Liporace F, Capo JT. Complex proximal ulna fractures: outcomes of surgical treatment. Eur J Orthop Surg Traumatol 2015;25(5):851-8.
- George AV, Lawton JN. Management of complications of forearm fractures. Hand Clin 2015;31(2):217-33.
- Cowal LS, Pastor RF. Dimensional variation in the proximal ulna: evaluation of a metric method for sex assessment. Am J Phys Anthropol 2008;135(4):469-78.
- Brownhill JR, Mozzon JB, Ferreira LM, Johnson JA, King GJ. Morphologic analysis of the proximal ulna with special interest in elbow implant sizing and alignment. J Shoulder Elbow Surg 2009;18(1):27-32.
- Totlis T, Anastasopoulos N, Apostolidis S, Paraskevas G, Terzidis I, Natsis K. Proximal ulna morphometry: which are the "true" anatomical preshaped olecranon plates? Surg Radiol Anat 2014;36(10):1015-22.
- Hopf JC, Jähnig A, Jorg T, Westphal RS, Wagner D, Rommens PM. Computer tomographic analysis of anatomic characteristics of the ulna - essential parameters for preshaped implants. PLoS One 2020;15(5):e0232988.
- Puchwein P, Schildhauer TA, Schöffmann S, Heidari N, Windisch G, Pichler W. Three-dimensional morphometry of the proximal ulna: a comparison to currently used anatomically preshaped ulna plates. J Shoulder Elbow Surg 2012;21:1018-23.
- Chapleau J, Joly-Chevrier M, Tohmé P, El-Kayem E, Petit Y, Rouleau DM. A novel fragment specific classification of complex olecranon fractures: 3-dimensional model design, radiological validation, and proposed surgical algorithm. J Shoulder Elbow Surg 2024;33(5):1084-91.
- Anderson ML, Larson AN, Merten SM, Steinmann SP. Congruent elbow plate fixation of olecranon fractures. J Orthop Trauma 2007;21(6):386-93.
- Niéto H, Billaud A, Rochet S, Lavoinne N, Loubignac F, Pietu G, Baroan C, Espie A, Bonnevialle P, Fabre T. Proximal ulnar fractures in adults: a review of 163 cases. Injury 2015;46 Suppl 1:S18-23.
- Hamoodi Z, Duckworth AD, Watts AC. Olecranon Fractures: A Critical Analysis Review. JBJS Rev 2023;11(1).
- Wadia F, Kamineni S, Dhotare S, Amis A. Radiographic measurements of normal elbows: clinical relevance to olecranon fractures. Clin Anat 2007;20(4):407-10.
- Keener JD, Chafik D, Kim HM, Galatz LM, Yamaguchi K. Insertional anatomy of the triceps brachii tendon. J Shoulder Elbow Surg 2010;19(3):399-405.
- Singh J, Pahuja K, Singh T. Morphometric study of proximal ulna with special emphasis on angulations. J Anat Soc India 2015;64:S12-17.
- Ndou R, Schepartz LA. Morphometric Characteristics of the Humerus and Ulna in Limbs Bearing the Supratrochlear Aperture (STA). Anat Rec (Hoboken) 2016;299(2):220-33.
- Walch A, Garcia-Maya B, Knowles NK, Athwal GS, King GJW. Computed tomography analysis of the relationship between the coronoid and the radial head. J Shoulder Elbow Surg 2021;30(12):2824-31.
- Öztürk K, Özdemir B, Dursun A, Kastamoni Y, Albay S. Anatomical architecture and angulations of the proximal ulna. Med J SDU 2021;28(3):419-26.
- Monum T, Jongmuenwai W, Thunyacharoen S, Sinthhubua A, Prasitwattanaseree S, Mahakkanukrauh P. Sex Estimation Using Ulna in a Thai Population. Int J Morphology 2021;39(6):1535-42.
- Wegmann S, Rausch V, Hackl M, Leschinger T, Scaal M, Müller LP, Wegmann K. Anatomic evaluation of the triceps tendon insertion at the proximal olecranon regarding placement of fracture fixation devices. Surg Radiol Anat 2022;44(4):627-34.
- Aydın Kabakcı DA. Anatomical Structure of the Proximal Part of the Ulna. J Harran University Medical Faculty 2022;19(2):412-20.
- Lavigne G, Baratz M. Fractures of the olecranon. J Am Soc Surg Hand 2004;4(2):94–102.
- Mulieri PJ, Frankle MA, Mighell MA. Fractures of the Olecranon and Complex Fracture–Dislocations of the Proximal Ulna and Radial Head. In: Stanley D, Trail I (eds) Operative elbow surgery. UK: Elsevier; 2012:329–45.
- Windisch G, Clement H, Grechenig W, Tesch NP, Pichler W. The anatomy of the proximal ulna. J shoulder elbow surg 2007;16(5):661–6.
Morphometric analysis of proximal ulna: An anatomical study
Abstract
Aim: To investigate proximal ulna morphometry through a detailed analysis of 107 dry ulnae and to assert its possible clinical relevance.
Materials and Methods: A total of 107 (52 left, 55 right) dry ulnae were evaluated. The ulna lengths, olecranon, and trochlear measurements were performed. All measurements were carried on with a 0.01 mm sensitive digital caliper.
Results: The mean ulna length and ulna length excluding trochlear notch were 261.17±43.07 mm and, 232.37±43.17 mm, respectively. The mean posterior olecranon height, middle olecranon height, and anterior olecranon height were obtained as 24.05±2.36 mm, 17.80±1.70 mm, and 35.15±3.60 mm, respectively. The mean olecranon width was 23.20±2.79 mm. Moreover, the mean trochlear notch width, radial trochlear notch width, and ulnar trochlear notch width were 22.79±2.81 mm, 24.80±2.69 mm, and 30.14±3.05 mm, respectively. The mean radial trochlear height, ulnar trochlear height were 13.45±2.26 mm and 14.69±2.23 mm, respectively. Lastly, the mean radial notch height, radial notch width, radial notch-olecranon posterior, and radial notch-olecranon anterior were measured as 11.15±1.94 mm, 18.02±2.60 mm, 12.91±2.92 mm, and 30.94±4.62 mm, respectively.
Conclusion: The findings of current study may be useful in the application of dorsal plates, intramedullary screw fixation and anatomically pre-shaped plates for the management of proximal ulna fractures.
Keywords
References
- Fornalski S, Gupta R, Lee TQ. Anatomy and biomechanics of the elbow joint. Tech Hand Up Extrem Surg 2003;7:168-78.
- Wang D, Li J, Xu G, Zhang H, Xu C, Zhang W, Li H, Gan X, Xiong Y, Zhang L, Li L, Tang P. Morphometric feature description of the proximal ulna based on quantitative measurement: a key consideration for implant design. Surg Radiol Anat 2023;45(2):215-24.
- Masood QM, Qulaghassi M, Grewal U, Bawale R, Kammela M, Singh B. Proximal ulna fractures in adults: A review of diagnosis and management. J Orthop Trauma 2021;20:101481.
- Duckworth AD, Carter TH, Chen MJ, Gardner MJ, Watts AC. Olecranon fractures: current treatment concepts. Bone Joint J 2023;105:112-23.
- Siebenlist S, Buchholz A, Braun KF. Fractures of the proximal ulna: current concepts in surgical management. EFORT Open Rev 2019;4(1):1-9.
- Beşer CG, Demiryürek D, Özsoy H, Erçakmak B, Hayran M, Kızılay O, Özsoy A. Redefining the proximal ulna anatomy. Surg Radiol Anat 2014;36(10):1023-31.
- Erdem H. Surgical importance of radiographically aided morphometry of the proximal ulna. Int J Morphol 2020;38(2):299-304.
- Rouleau DM, Faber KJ, Athwal GS. The proximal ulna dorsal angulation: a radiographic study. J Shoulder Elbow Surg 2010;19(1):26-30.
- Morrey BF, An KN. Stability of the elbow: osseous constraints. J Shoulder Elbow Surg 2005;14(1 Suppl S):174S-8S.
- Melamed E, Danna N, Debkowska M, Karia R, Liporace F, Capo JT. Complex proximal ulna fractures: outcomes of surgical treatment. Eur J Orthop Surg Traumatol 2015;25(5):851-8.
- George AV, Lawton JN. Management of complications of forearm fractures. Hand Clin 2015;31(2):217-33.
- Cowal LS, Pastor RF. Dimensional variation in the proximal ulna: evaluation of a metric method for sex assessment. Am J Phys Anthropol 2008;135(4):469-78.
- Brownhill JR, Mozzon JB, Ferreira LM, Johnson JA, King GJ. Morphologic analysis of the proximal ulna with special interest in elbow implant sizing and alignment. J Shoulder Elbow Surg 2009;18(1):27-32.
- Totlis T, Anastasopoulos N, Apostolidis S, Paraskevas G, Terzidis I, Natsis K. Proximal ulna morphometry: which are the "true" anatomical preshaped olecranon plates? Surg Radiol Anat 2014;36(10):1015-22.
- Hopf JC, Jähnig A, Jorg T, Westphal RS, Wagner D, Rommens PM. Computer tomographic analysis of anatomic characteristics of the ulna - essential parameters for preshaped implants. PLoS One 2020;15(5):e0232988.
- Puchwein P, Schildhauer TA, Schöffmann S, Heidari N, Windisch G, Pichler W. Three-dimensional morphometry of the proximal ulna: a comparison to currently used anatomically preshaped ulna plates. J Shoulder Elbow Surg 2012;21:1018-23.
- Chapleau J, Joly-Chevrier M, Tohmé P, El-Kayem E, Petit Y, Rouleau DM. A novel fragment specific classification of complex olecranon fractures: 3-dimensional model design, radiological validation, and proposed surgical algorithm. J Shoulder Elbow Surg 2024;33(5):1084-91.
- Anderson ML, Larson AN, Merten SM, Steinmann SP. Congruent elbow plate fixation of olecranon fractures. J Orthop Trauma 2007;21(6):386-93.
- Niéto H, Billaud A, Rochet S, Lavoinne N, Loubignac F, Pietu G, Baroan C, Espie A, Bonnevialle P, Fabre T. Proximal ulnar fractures in adults: a review of 163 cases. Injury 2015;46 Suppl 1:S18-23.
- Hamoodi Z, Duckworth AD, Watts AC. Olecranon Fractures: A Critical Analysis Review. JBJS Rev 2023;11(1).
- Wadia F, Kamineni S, Dhotare S, Amis A. Radiographic measurements of normal elbows: clinical relevance to olecranon fractures. Clin Anat 2007;20(4):407-10.
- Keener JD, Chafik D, Kim HM, Galatz LM, Yamaguchi K. Insertional anatomy of the triceps brachii tendon. J Shoulder Elbow Surg 2010;19(3):399-405.
- Singh J, Pahuja K, Singh T. Morphometric study of proximal ulna with special emphasis on angulations. J Anat Soc India 2015;64:S12-17.
- Ndou R, Schepartz LA. Morphometric Characteristics of the Humerus and Ulna in Limbs Bearing the Supratrochlear Aperture (STA). Anat Rec (Hoboken) 2016;299(2):220-33.
- Walch A, Garcia-Maya B, Knowles NK, Athwal GS, King GJW. Computed tomography analysis of the relationship between the coronoid and the radial head. J Shoulder Elbow Surg 2021;30(12):2824-31.
- Öztürk K, Özdemir B, Dursun A, Kastamoni Y, Albay S. Anatomical architecture and angulations of the proximal ulna. Med J SDU 2021;28(3):419-26.
- Monum T, Jongmuenwai W, Thunyacharoen S, Sinthhubua A, Prasitwattanaseree S, Mahakkanukrauh P. Sex Estimation Using Ulna in a Thai Population. Int J Morphology 2021;39(6):1535-42.
- Wegmann S, Rausch V, Hackl M, Leschinger T, Scaal M, Müller LP, Wegmann K. Anatomic evaluation of the triceps tendon insertion at the proximal olecranon regarding placement of fracture fixation devices. Surg Radiol Anat 2022;44(4):627-34.
- Aydın Kabakcı DA. Anatomical Structure of the Proximal Part of the Ulna. J Harran University Medical Faculty 2022;19(2):412-20.
- Lavigne G, Baratz M. Fractures of the olecranon. J Am Soc Surg Hand 2004;4(2):94–102.
- Mulieri PJ, Frankle MA, Mighell MA. Fractures of the Olecranon and Complex Fracture–Dislocations of the Proximal Ulna and Radial Head. In: Stanley D, Trail I (eds) Operative elbow surgery. UK: Elsevier; 2012:329–45.
- Windisch G, Clement H, Grechenig W, Tesch NP, Pichler W. The anatomy of the proximal ulna. J shoulder elbow surg 2007;16(5):661–6.
Details
| Primary Language | English |
|---|---|
| Subjects | Orthopaedics, Anatomy |
| Journal Section | Research Articles |
| Authors | |
| Publication Date | September 8, 2025 |
| Submission Date | March 26, 2025 |
| Acceptance Date | June 30, 2025 |
| Published in Issue | Year 2025 Volume: 64 Issue: 3 |
