Correlation between modified trochleocapitellar index and post-traumatic elbow stiffness in type C2-3 distal humeral fractures among adults

Hua, Kehan; Ji, Shangwei; Li, Ting; Chen, Chen; Zha, Yejun; Gong, Maoqi; Sun, Weitong; Lü, Sihua; Jiang, Xieyuan

doi:10.1016/j.jse.2020.02.016

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…The in vivo continuous flexion motion measurement plays an essential role in understanding the elbow flexion movement pattern. Studies have shown that various factors would affect elbow motion, including the integrity of the ligament, the employing load, the effect of forearm rotation (pronation or supination), the active or passive motions, and geometrical characters (Duck et al, 2003a;Duck et al, 2003b;Hua et al, 2020). Morphologic studies about the distal elbow showed that the articular shape might vary among people, including the capitellum or trochlear diameters, articular width, and anatomic bow (Brownhill et al, 2007;Desai et al, 2014;Lenoir et al, 2015a).…”

Section: Introductionmentioning

confidence: 99%

Distal Humeral Trochlear Geometry Associated With the Spatial Variation of the Dynamic Elbow Flexion Axis

Zou

et al. 2022

Front. Bioeng. Biotechnol.

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Background: The complexity of the spatial dynamic flexion axis (DFA) of the elbow joint makes the elbow prosthesis design and humeral component alignment challenging. This study aimed to 1) investigate the variations of the spatial DFA during elbow flexion and 2) investigate the relationship between the distal humeral trochlear geometry and the in vivo spatial variation of the DFA.Methods: Ten healthy subjects participated in this study. Each subject performed a full elbow extension to maximum flexion with hand supination under dual fluoroscopic imaging system (DFIS) surveillance. The 2D fluoroscopic images and the 3D bone models were registered to analyze the in vivo elbow kinematics and DFAs. The spatial DFA positions were defined as inclination with the medial and lateral epicondyle axes (MLA) in the transverse and coronal planes. The range of the DFA positions was also investigated during different flexion phases. The Spearman correlation method was used to analyze the relationship between the distal humeral trochlear’s morphological parameters and the position of DFAs during different flexion phases.Results: The pathway of the DFAs showed an irregular pattern and presented individual features. The medial trochlear depth (MTD) (r = 0.68, p = 0.03) was positively correlated with the range of the DFA position (2.8° ± 1.9°) in the coronal plane from full extension to 30° of flexion. Lateral trochlear height (LTH) (r = −0.64, p = 0.04) was negatively correlated with the DFA position (−1.4° ± 3.3°) in the transverse plane from 30° to 60° of flexion. A significant correlation was found between LTH with the DFA position in the coronal (r = −0.77, p = 0.01) and transverse planes (r = −0.76, p = 0.01) from 60° to 90° of flexion.Conclusion: This study showed that the pathway of the dynamic flexion axis has an individual pattern. The medial and lateral trochlear sizes were the key parameters that might affect the elbow joint flexion function. When recovering complex distal humeral fractures or considering the implant design of total elbow arthroplasty, surgeons should pay more attention to the medial and lateral trochlea’s geometry, which may help restore normal elbow kinematics.

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