Anatomical considerations of the radius

Most radial head prostheses do not seem to be based on anatomic data. This may be due partly to the great variation of radial morphology. More importantly, few articles report on the dimensions of the radius. Authors have mainly studied dimensions of the radial head, with less emphasis to the relationship with the rest of the radius. Dimensions of, and relationship between, the proximal and the rest of the radius were measured on 27 fresh-frozen cadaveric upper extremities. Radial head, articulating surface, diaphysis, and distal radius were measured. Angles between the radial neck and diaphysis were defined and calculated. Axes of the distal and proximal radius were defined and radial torsion was calculated. Repeated measures were done by two observers in ten specimens. Inter- and intra-class correlation coefficients were very acceptable. Radial dimensions were found to be highly variable. Calculation of radial torsion showed the largest range. The average torsion was 54 degrees (range = 23-78 degrees). Radial length was 235 mm (range = 207-269 mm). Radial neck length was 13 mm (range = 9-19 mm). We found an average proximal diaphysis-neck angle of 17 degrees (range = 6-28 degrees). End to end-neck angle was 13 degrees (range = 4-22 degrees). Our findings indicate that even with a perfectly anatomical prosthesis, restoration of the anatomical situation can only be achieved when the implant is placed in the correct position. Instrumentation should be developed to allow accurate and reproducible implantation. The measurements we provide may aid this development.