Clin Orthop Surg.  2018 Dec;10(4):462-467. 10.4055/cios.2018.10.4.462.

Morphometric Variations in the Volar Aspect of the Distal Radius

• Kwon BC
• Lee JK
• Lee SY
• Hwang JY
• Seo JH

• KMID: 2426532
• DOI: http://doi.org/10.4055/cios.2018.10.4.462

Abstract

BACKGROUND
Significant discrepancy exists between anatomical plate designs and the anatomy of the native distal radius, which may be attributable to considerable morphometric variations in the volar aspect of the distal radius. We aimed to evaluate the degree of variability in the morphometry of the distal radius and identify factors associated with this variability.
METHODS
We measured the volar surface angle (VSA) of the intermediate and lateral columns and the volar surface width (VSW) in the distal radius from three-dimensional computed tomography scans acquired from 81 cadaveric forearms. These morphometric parameters were compared between the lateral and intermediate columns, between males and females, and between Koreans and Caucasians. Caucasian morphometric data were obtained and pooled from the previous studies. The coefficient of variation was used to assess the variability of the parameters and Cohen's d to estimate the effect size of the difference between groups.
RESULTS
The average VSA of the lateral column was 22°± 6°, and that of the intermediate column was 29°± 8° in Koreans (p < 0.001). The variability was high for both VSAs. The VSA of the intermediate column was significantly larger in males than in females (p < 0.001) and in Caucasians than in Koreans (p < 0.001). The average VSW of distal radius was 30 ± 3 mm at the watershed line, and it became narrower proximally. The VSW was significantly larger in males than in females (p < 0.001) and in Koreans than in Caucasians (p < 0.001). The effect sizes of the difference for the VSA and VSW between sexes, races and columns were medium to large.
CONCLUSIONS
Considerable variability exists in the morphometry of the volar distal radius, with sex, race, and column as contributing factors. These results suggest that surgeons should carefully choose an anatomical volar locking plate with appropriate angulation characteristics for each patient to achieve patient-specific alignment of the distal radius.

Keyword

Measurement; Radius; Bone plate; Variation; Anatomy

MeSH Terms

Bone Plates
Cadaver
Continental Population Groups
Female
Forearm
Humans
Male
Radius*
Surgeons

Figure

• 

  Fig. 1 Measurement methods of the volar surface angle (VSA) at the lateral column and the intermediate column, as well as the volar surface width (VSW) are shown. (A) The VSA at the lateral column is defined as the angle formed by the line along the volar surface of the radial shaft and the line along the volar surface of the radial metaphysis at the center of the scaphoid fossa. (B) The VSA at the intermediate column is defined as the angle formed by the lines drawn in the same fashion at the center of the lunate fossa. (C) The VSW is defined as the length of the line drawn from the lateral to the medial margin of the volar surface of the distal radius, perpendicular to the central axis of the radial shaft.

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