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Bones of the Upper Limb: Ulna01:15

Bones of the Upper Limb: Ulna

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Anatomic safe zone for proximal ulnar fixation: a cadaver study.

Tala Thammaroj1, Surut Jianmongkol, Kimaporn Kamanarong

  • 1Department of Orthopedics, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand. tekamo@kku.ac.th

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|October 12, 2007
PubMed
Summary

This study defines the safe zone on the proximal ulna for ulnar fixation. Surgeons should limit screw protrusion to 0.92 cm in the sagittal plane to avoid neurovascular injury.

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Area of Science:

  • Orthopedic Surgery
  • Anatomy
  • Biomechanics

Background:

  • Proximal ulna fractures are common and require surgical fixation.
  • Accurate placement of fixation devices is crucial to avoid neurovascular complications.
  • The 'safe zone' for ulnar fixation requires precise anatomical definition.

Purpose of the Study:

  • To determine the anatomical safe zone on the volar surface of the proximal ulna.
  • To characterize this safe zone relative to bony landmarks for ulnar fixation.
  • To guide the protrusion depth of fixation devices like screws and K-wires.

Main Methods:

  • Analysis of 39 upper extremities from 20 human cadavers.
  • Measurement of safe zone dimensions in both coronal and sagittal planes.
  • Evaluation of distances between the median nerve and proximal ulna.

Main Results:

  • In the sagittal plane, median nerve distance was 0.99 cm (2 cm distal) and 0.85 cm (4 cm distal) to the coronoid process.
  • In the coronal plane, distances ranged from 0.82 cm to 0.95 cm at 2 cm and 4 cm distal to the coronoid process.
  • These measurements define critical boundaries for safe fixation protrusion.

Conclusions:

  • Fixation devices should reach the proximal ulna's cortical bone but not protrude beyond defined limits.
  • Sagittal plane protrusion should not exceed 0.92 cm to prevent neurovascular injury.
  • Surgeons must exercise vigilance due to the high risk of neurovascular injury with proximal ulna fixation.