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Computed Tomography-Based Templating of Proximal Ulna Intramedullary Screw Fixation
Nitin Goyal1, Dominic Coutinho1, Anish Ghodadra2
1Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, PA, USA.
Hand (New York, N.Y.)
|July 17, 2023
Summary
This study analyzed proximal ulna anatomy for intramedullary screw fixation in total elbow arthroplasty. Templating accurately predicts screw size, indicating a need for varied screw lengths and diameters for optimal fixation.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Radiology
Background:
- Intramedullary screw fixation is utilized for the ulnar component in total elbow arthroplasty.
- Accurate anatomical characterization is crucial for successful screw fixation.
Purpose of the Study:
- To characterize proximal ulna anatomy using computed tomography (CT) for intramedullary screw fixation.
- To validate templating by inserting screws into 3D-printed models.
Main Methods:
- CT scans of 30 elbows were analyzed to template screw placement.
- 3D models were created for 5 patients to physically test screw insertion.
Main Results:
- Anatomical limitations (angulation) were identified for screw fixation.
- Mean screw diameter was 5.4 mm, and mean screw length was 79.9 mm when templated.
- Screws in 3D models closely matched templated lengths (correlation 0.992).
Conclusions:
- Proximal ulna anatomy presents specific challenges for intramedullary screw fixation.
- Preoperative templating aids in predicting screw size for total elbow arthroplasty.
- A wide range of screw dimensions is necessary for successful intramedullary fixation.
