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Regional variations in radial head bone volume and density: implications for fracture patterns and fixation
John P Haverstock1, Ryan N Katchky, Emily A Lalone
1Hand and Upper Limb Centre, St. Joseph's Health Care, University of Western Ontario, London, ON, Canada.
Journal of Shoulder and Elbow Surgery
|September 25, 2012
Summary
Radial head bone density and volume are highest in the posteromedial region and lowest in the anterolateral region, which correlates with common fracture sites. This finding aids in understanding radial head fracture mechanisms.
Area of Science:
- Orthopedic surgery
- Biomechanics
- Radiology
Background:
- Radial head fractures are common, often involving an anterolateral fragment.
- The precise mechanism of radial head fracture remains unclear, but bone density and transmitted forces are implicated.
- Understanding regional bone variations is key to elucidating fracture pathomechanics.
Purpose of the Study:
- To quantify regional variations in bone density and volume within the radial head.
- To correlate these variations with common radial head fracture patterns.
Main Methods:
- Computed tomography (CT) scans of 18 cadaver elbows were analyzed.
- The radial head was divided into four quadrants based on forearm rotation.
- Bone density (Hounsfield units) and volume (mm³) were calculated and compared across quadrants.
Main Results:
- Bone density was highest in the posteromedial (PM) quadrant (496 HU) and lowest in the anterolateral (AL) quadrant (406 HU).
- Bone volume was greatest in the PM quadrant (1138 mm³) and least in the AL quadrant (938 mm³).
- Significant differences in density and volume were observed between multiple quadrants (P < .05).
Conclusions:
- The posteromedial quadrant of the radial head exhibits the highest bone density and volume.
- The anterolateral quadrant, where fractures frequently occur, is comparatively less dense and has less bone volume.
- These regional variations likely play a role in the pathomechanics of radial head fractures.
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