title: Morphological Study of the Proximal Fibular Articular Surface Using Computed Tomography: Which Side Is Preferred for Proximal Fibular Flap in Wrist Arthroplasty?
abstract: BackgroundAlthough proximal fibular flaps have been widely applied in wrist arthroplasty, controversy remains regarding which side of the proximal fibula is better for reconstruction of the distal radius. If the articular surface of the proximal fibula shows dorsal tilting, the ipsilateral (right) proximal fibula should be harvested in right wrist arthroplasty because the articular surface of the distal radius normally has volar tilt. This study investigated anatomical similarities between the proximal fibular articular surface and the distal radius articular surface based on morphologic analysis of the proximal fibula using computed tomography (CT).MethodsA total of 18 proximal fibulae from 18 adult volunteers were analyzed using CT. Tilt and length of the proximal fibular articular surface were measured in the section plane parallel to the proximal tibiofibular articular surface (simulated sagittal plane). The inclination angle of the articular surface was measured in the section plane perpendicular to the proximal tibiofibular articular surface (simulated coronal plane).ResultsIn the simulated sagittal plane, the articular surface of the proximal fibula showed a mean dorsal tilt of 4.1 degrees; the articular surface for each scan was 17.1 mm. In the simulated coronal plane, two articular surfaces were studied. The inclination angle of these surfaces was measured as 32.2 and 54.4 degrees, respectively.ConclusionCT analysis of the proximal fibular articular surfaces suggested that ipsilateral proximal fibular transfer can result in improved anatomic restoration of normal volar tilt of the distal radius due to dorsal tilt of the proximal fibular articular surface.
authors: Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: Jae Hoon
authors: JH
authors: Lee
authors: Department of Orthopedic Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: Duke Whan
authors: DW
authors: Chung
authors: Department of Orthopedic Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: Jong Hun
authors: JH
authors: Baek
authors: Department of Orthopedic Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: Young Jun
authors: YJ
authors: Kim
authors: Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: So Young
authors: SY
authors: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D001178:Arthroplasty / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005360:Fibula / Q000637:transplantation*; D006801:Humans; D008297:Male; D011884:Radius / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016059:Range of Motion, Articular; D013499:Surface Properties; D013524:Surgical Flaps; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult