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Bones of the Upper Limb: Ulna

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The ulna and radius are parallel bones of the antebrachium or the forearm. The ulna lies medially and consists of a bony tip called the olecranon process at its proximal end. This hook-like projection articulates with the olecranon fossa of the humerus and forms the "hinged" ulnohumeral part of the elbow joint. This joint facilitates forearm extension and flexion while preventing its hyperextension. Similarly, the coronoid process, another bony projection on the proximal/anterior side...

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Distal Ulna Reconstruction using the Second Metatarsal: Anatomical Study.

Pedro C Cavadas¹, Alessandro Thione¹, Isabel Elía Martinez²

¹Reconstructive Surgery, Clinica Cavadas, Valencia, Spain.

Journal of Wrist Surgery

|April 23, 2016

Summary

The second metatarsal (MT2) head shows similar cylindrical morphology to the distal ulna, suggesting potential for wrist reconstruction. Osteotomy and rotation of the MT2 head improve shape similarity for potential autologous transfer.

Keywords:

DRUJ second metatarsal ulnar head

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Area of Science:

Orthopedic surgery
Anatomical studies
Biomechanical research

Background:

The distal ulna is crucial for wrist and forearm stability.
Reconstruction options for distal ulna defects are limited.
The second metatarsal (MT2) is explored as a potential graft source.

Purpose of the Study:

To anatomically compare the distal ulnar head and the second metatarsal (MT2) head.
To evaluate the feasibility of using the MT2 for distal ulna reconstruction.

Main Methods:

3D CT scans of wrists and feet from 52 patients and 11 cadavers.
Measurement of radius and height of best-fit cylinders for both epiphyses.
Osteotomy and 90-degree rotation of the MT2 head in cadaveric specimens.

Main Results:

Both distal ulna and MT2 heads exhibit cylindrical morphology.
MT2 head has a similar radius but greater height than the distal ulna.
Post-osteotomy, the MT2 head's shape and orientation closely resemble the distal ulna.

Conclusions:

The second metatarsal (MT2) head is a morphologically viable option for distal ulna reconstruction.
A vascularized MT2 transfer, after rotation osteotomy, could be a future reconstructive technique.
Further research is required on vascular supply, ligamentous, and sigmoid notch reconstruction.