Journal of Shoulder and Elbow Surgery
Volume 18, Issue 1 , Pages 27-32, January 2009

Morphologic analysis of the proximal ulna with special interest in elbow implant sizing and alignment

  • James R. Brownhill, PhD

      Affiliations

    • Department of Biomedical Engineering, The University of Western Ontario, Ontario, Canada
    • ,
  • Jeremy B. Mozzon, MD, BESc

      Affiliations

    • Department of Biomedical Engineering, The University of Western Ontario, Ontario, Canada
    • ,
  • Louis M. Ferreira, BSc, BESc

      Affiliations

    • Department of Biomedical Engineering, The University of Western Ontario, Ontario, Canada
    • ,
  • James A. Johnson, PhD

      Affiliations

    • Department of Biomedical Engineering, The University of Western Ontario, Ontario, Canada
    • Department of Surgery, The University of Western Ontario, Ontario, Canada
    • Department of Medical Biophysics, The University of Western Ontario, Ontario, Canada
    • ,
  • Graham J.W. King, MD, MSc, FRCSC

      Affiliations

    • Bioengineering Research Laboratory, The Hand and Upper Limb Center, St. Joseph's Health Care London, London, Canada
    • Department of Surgery, The University of Western Ontario, Ontario, Canada
    • Department of Medical Biophysics, The University of Western Ontario, Ontario, Canada
    • Corresponding Author InformationReprint requests: Graham J. W. King, MD, MSc, FRCSC, The Hand and Upper Limb Center, St. Joseph's Health Care London, 268 Grosvenor Street, London, Ontario, Canada, N6A 4L6.

published online 04 August 2008.

Summary 

A better understanding of the morphology of the proximal ulna should permit the development of ulnar component designs which have an improved fit to the native bone, thus leading to more accurate implant positioning. Computed-tomography (CT) scans of 31 cadaveric proximal ulnae were analyzed using computer aided design software to determine the shape of the medullary canal relative to the articular surface. The diameter, curvature, cross-sectional centroid position, and coronal and sagittal angulation of the ulnar canal were all calculated with respect to the center of the greater sigmoid notch. Posterior and lateral offsets increased distally from the articulation center, and the mean diameter of the canal was larger in males than in females (P < .05). The average valgus angulation was 8.0 ± 4.0° for males and 7.2 ± 3.1° for females (P = .6). Longer stemmed ulnar implants may require a modular design to meet anatomic constraints during implant positioning.

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 This study received funding from the The Natural Sciences and Engineering Research Council of Canada - Collaborative Health Research Partnership and Canadian Institutes for Health Research.

PII: S1058-2746(08)00393-5

doi:10.1016/j.jse.2008.03.008

Journal of Shoulder and Elbow Surgery
Volume 18, Issue 1 , Pages 27-32, January 2009

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