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Updated: Jan 27, 2026
Assessment of Bone Fracture Healing Using Micro-Computed Tomography
Published on: December 9, 2022
Involvement of the proximal radial ulnar joint in partial radial head fractures: a novel three-dimensional computed
Anne Couture1, Jonah Hébert-Davies1,2, Julien Chapleau1
1Université de Montréal, Montreal, QC, Canada.
Background:
Partial radial head fractures (PRHF) can involve the proximal radioulnar joint (PRUJ) or be restricted to the 'safe zone' (SZ) during forearm rotation. The objective of the present study was to develop an assessment method for PRUJ involvement in radial head fractures using axial computed tomography (CT) scans.
Methods:
The area of the radial head in contact with the PRUJ zone was identified, and defined on 18 cadaveric elbows CT scans; the quantitative relationship between PRUJ zone and radial tuberosity was established. Then, four evaluators validated it on PRHF CT scan axial views, classifying the fractures as involving the PRUJ or not.
Results:
Using the radial tuberosity as the 0° of a 360° circle, the SZ was within 108° to 212° clockwise for a right elbow and counter clockwise for the left elbow. Fifty-five consecutive (30 men, 25 women, mean age of 49 years) partial radial head fracture CT scans were classified: four in the SZ only, three in the PRUJ zone and 48 in both the PRUJ and SZ. The kappa for the inter- and intra-observer agreement was 0.517 and 0.881, respectively.
Conclusions:
Ninety-three percent of partial radial head fractures will involve the PRUJ and the geometric model developed allows their classification, potentially helping surgeons decide on optimal treatment.
Level Of Evidence:
Retrospective basic science study. Level III: anatomic study, imaging.
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