Anatomic Considerations for Plating of the Distal Ulna
Anatomic Considerations for Plating of the Distal Ulna
复制标题
DOI：
10.1055/s-0035-1556864
复制
发表时间：
2015-08-01
影响因子：
0.7
通讯作者：
Bindra, Randy
中科院分区：
文献类型：
--
作者：
Hazel, Antony;Nemeth, Nicole;Bindra, Randy
目的-我们的研究的目的是检查尺骨远端的解剖结构，并确定一个间隔，这将是适合于电镀，不会造成冲击，在手腕旋转，也不会刺激尺侧腕伸肌（ECU）tendon.Methods的尸体前臂解剖和远端尺骨关节面的弧进行了测量。尺骨远端被划分为一个钟面，尺骨茎突被分配到12点钟位置，并相应地确定ECU的位置。同时测量尺茎突至尺背感觉神经掌背交叉处的距离。根据这些测量的安全区defined.Results之间的12和2点钟的位置上的右手腕，和10和12点钟之间的左手腕确定了一个安全区。尺神经背侧感觉分支在尺侧茎突附近的不同位置从掌侧穿至背侧。两个市售的板被利用，并可以放置在我们指定的间隔，并没有造成冲击时，forearmwas旋转fully.Conclusion我们的研究表明，在前臂旋转过程中，避免冲击的远端尺骨，这是一个位置电镀的足迹外的ECU subsheath。临床意义尺骨远端骨折可能需要钢板固定，尽管钢板放置可能取决于骨折类型，但重要的是要了解钢板放置的意义。尽管由于粉碎性骨折，可能无法获得理想的接骨板，但可以对患者进行关于肌腱刺激、活动度丧失或是否需要取出内固定器械的教育。
Purpose The purpose of our study was to examine the anatomy of the distal ulna and identify an interval that would be amenable to plating and would not cause impingement during wrist rotation nor irritation to the extensor carpi ulnaris (ECU) tendon.Methods Six cadaveric forearms were dissected and the arc of the articular surface of the distal ulna was measured. The distal ulna was divided up as a clock face, with the ulnar styloid being assigned the 12 o'clock position, and the location of the ECU was identified accordingly. The distance from the ulnar styloid to where the dorsal sensory ulnar nerve crosses from volar to dorsal was also measured. Based on these measurements a safe zone was defined.Results A safe zone was identified between the 12 and 2 o'clock position on the right wrist, and between the 10 and 12 o'clock on the left wrist. The dorsal sensory branch of the ulnar nerve crossed from volar to dorsal position at a variable location near the ulnar styloid. Two commercially available plates were utilized and could be placed in our designated interval and did not cause impingement when the forearmwas rotated fully.Conclusion Our study demonstrates a location for plating of the distal ulna that avoids impingement during forearm rotation and that is outside of the footprint of the ECU subsheath. Clinical Relevance Plating of the distal ulna may be necessary with distal ulna fracture, and although plate placementmay be dictated by the fracture pattern, it is important to understand the implications of plate placement. Although the ideal plate may not be possible because of comminution, the patient can be educated in regards to potential for tendon irritation, loss of motion, or need for hardware removal.