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The proximal ulna dorsal angulation: a radiographic study
Dominique M Rouleau1, Kenneth J Faber, George S Athwal
1Hand and Upper Limb Center, St Joseph's Health Care, University of Western Ontario, Ontario, Canada.
Journal of Shoulder and Elbow Surgery
|October 1, 2009
Summary
Proximal ulna dorsal angulation (PUDA) is present in 96% of patients, averaging 5.7 degrees. This measurement is reliable for guiding anatomic plating in ulna surgeries.
Area of Science:
- Orthopedic surgery
- Radiology
- Anatomy
Background:
- Accurate reduction of proximal ulna fractures, nonunions, malunions, or osteotomies is crucial.
- Newer straight precontoured ulnar plates necessitate precise understanding of proximal ulna dorsal angulation (PUDA).
Purpose of the Study:
- To characterize the proximal ulna dorsal angulation (PUDA) in a patient cohort.
- To assess the reliability of PUDA measurements.
Main Methods:
- Bilateral elbow radiographs from 50 patients were analyzed using commercial software.
- Proximal ulna dorsal angulation (PUDA) and olecranon tip-to-apex distance were measured.
- Intraobserver and interobserver reliability was assessed by three orthopedic surgeons.
Main Results:
- A PUDA was identified in 96% of radiographs, with an average angle of 5.7 degrees.
- A strong side-to-side correlation (r=0.860, P < .001) was observed for PUDA.
- Excellent intraobserver and good interobserver reliability were found for PUDA measurements.
Conclusions:
- The average PUDA is 5.7 degrees, found in 96% of patients, approximately 47mm distal to the olecranon tip.
- PUDA measurement demonstrates reliable intraobserver and interobserver consistency.
- Recognizing PUDA aids in achieving anatomic plating for various ulna conditions.
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