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Characterization of the Supinator Tubercle for Lateral Ulnar Collateral Ligament Reconstruction.

Anakwenze OA, Khanna K, Levine WN, Ahmad CS - Orthop J Sports Med (2014)

Bottom Line: The supinator tubercle was found to be prominent in 5 of 10 ulnar models.The distance between the radial head junction and the supinator tubercle was found to be 15 ± 2.37 mm, and the distance from the supinator crest at the radial head junction to the posterior cortex was 10.25 ± 2.07 mm.Results of this study may aid proper anatomic LUCL reconstruction.

View Article: PubMed Central - PubMed

Affiliation: Kaiser Permanente, San Diego, California, USA.

ABSTRACT

Background: Lateral ulnar collateral ligament (LUCL) reconstruction requires proper understanding and identification of anatomic structures about the lateral elbow. The insertion site of the LUCL is based on the supinator tubercle.

Purpose: To characterize the supinator tubercle relative to other surrounding anatomic landmarks.

Study design: Descriptive laboratory study.

Methods: Computed tomography (CT) scans of 10 adult elbows were retrospectively reviewed. These CT scans were converted into patient-specific 3-dimensional computer models. Using a user-defined coordinate system, an ulnar Cartesian coordinate system was defined with anatomic landmarks as reference points to standardize the position of each model. The length of the supinator crest was measured. Following this, the crest was examined for a distinct raised bony tuberosity that would be consistent with the supinator tubercle. If no distinctly raised tubercle was noted, the most prominent appearing location of the crest distal to the radial notch was considered the tubercle. The distance from the proximal radial head junction to the supinator tubercle was recorded. Finally, the distance from the supinator crest at the radial head junction to the posterior cortex in the sagittal plane was measured.

Results: The supinator tubercle was found to be prominent in 5 of 10 ulnar models. The supinator crest was 43.59 ± 13.28 mm long, and the supinator tubercle lateral extrusion was 5.60 ± 0.90 mm. The distance between the radial head junction and the supinator tubercle was found to be 15 ± 2.37 mm, and the distance from the supinator crest at the radial head junction to the posterior cortex was 10.25 ± 2.07 mm.

Conclusion: The supinator tubercle is frequently not prominent or easily recognizable. Its relationship to other structures is of value. The proximal border of the radial head, residing 15 mm proximal to the most predictable location of the supinator tubercle, is a useful landmark when drilling tunnels during LUCL reconstructions.

Clinical relevance: Results of this study may aid proper anatomic LUCL reconstruction.

No MeSH data available.


Related in: MedlinePlus

Functional anatomy of the ligaments of the elbow. Evaluation of supinator tubercle on supinator crest. These models evaluated the presence of specific bony protuberance in the supinator crest that would represent the supinator tubercle.
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fig3-2325967114530969: Functional anatomy of the ligaments of the elbow. Evaluation of supinator tubercle on supinator crest. These models evaluated the presence of specific bony protuberance in the supinator crest that would represent the supinator tubercle.

Mentions: Measurements of the supinator crest were made by examining the lateral aspect of the ulnar models in the sagittal plane. The length of the supinator crest was measured from the proximal origin at the posterior aspect of the radial notch to the point at which it became indistinguishable from the normal contours of the ulnar cortex (Figure 2). The crest was then examined for a distinct raised bony tuberosity, which would represent the supinator tubercle (Figure 3). The tubercle extrusion of the tubercle from the existing ulnar cortex was measured in the coronal plane (Figure 2). If no distinctly raised tubercle was noted, then the most prominent appearing location of the crest distal to the radial notch was considered the tubercle. The 3-dimensional model of the radius was overlaid on the ulnar model to determine the projection of the center of the radial head onto the ulna, and the distance from this radial head junction to the supinator tubercle was recorded (Figure 2). Finally, the distance from the supinator crest at the radial head junction to the posterior cortex in the sagittal plane was measured, as proximal ulnar tunnels, when used, are in this location.


Characterization of the Supinator Tubercle for Lateral Ulnar Collateral Ligament Reconstruction.

Anakwenze OA, Khanna K, Levine WN, Ahmad CS - Orthop J Sports Med (2014)

Functional anatomy of the ligaments of the elbow. Evaluation of supinator tubercle on supinator crest. These models evaluated the presence of specific bony protuberance in the supinator crest that would represent the supinator tubercle.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4555592&req=5

fig3-2325967114530969: Functional anatomy of the ligaments of the elbow. Evaluation of supinator tubercle on supinator crest. These models evaluated the presence of specific bony protuberance in the supinator crest that would represent the supinator tubercle.
Mentions: Measurements of the supinator crest were made by examining the lateral aspect of the ulnar models in the sagittal plane. The length of the supinator crest was measured from the proximal origin at the posterior aspect of the radial notch to the point at which it became indistinguishable from the normal contours of the ulnar cortex (Figure 2). The crest was then examined for a distinct raised bony tuberosity, which would represent the supinator tubercle (Figure 3). The tubercle extrusion of the tubercle from the existing ulnar cortex was measured in the coronal plane (Figure 2). If no distinctly raised tubercle was noted, then the most prominent appearing location of the crest distal to the radial notch was considered the tubercle. The 3-dimensional model of the radius was overlaid on the ulnar model to determine the projection of the center of the radial head onto the ulna, and the distance from this radial head junction to the supinator tubercle was recorded (Figure 2). Finally, the distance from the supinator crest at the radial head junction to the posterior cortex in the sagittal plane was measured, as proximal ulnar tunnels, when used, are in this location.

Bottom Line: The supinator tubercle was found to be prominent in 5 of 10 ulnar models.The distance between the radial head junction and the supinator tubercle was found to be 15 ± 2.37 mm, and the distance from the supinator crest at the radial head junction to the posterior cortex was 10.25 ± 2.07 mm.Results of this study may aid proper anatomic LUCL reconstruction.

View Article: PubMed Central - PubMed

Affiliation: Kaiser Permanente, San Diego, California, USA.

ABSTRACT

Background: Lateral ulnar collateral ligament (LUCL) reconstruction requires proper understanding and identification of anatomic structures about the lateral elbow. The insertion site of the LUCL is based on the supinator tubercle.

Purpose: To characterize the supinator tubercle relative to other surrounding anatomic landmarks.

Study design: Descriptive laboratory study.

Methods: Computed tomography (CT) scans of 10 adult elbows were retrospectively reviewed. These CT scans were converted into patient-specific 3-dimensional computer models. Using a user-defined coordinate system, an ulnar Cartesian coordinate system was defined with anatomic landmarks as reference points to standardize the position of each model. The length of the supinator crest was measured. Following this, the crest was examined for a distinct raised bony tuberosity that would be consistent with the supinator tubercle. If no distinctly raised tubercle was noted, the most prominent appearing location of the crest distal to the radial notch was considered the tubercle. The distance from the proximal radial head junction to the supinator tubercle was recorded. Finally, the distance from the supinator crest at the radial head junction to the posterior cortex in the sagittal plane was measured.

Results: The supinator tubercle was found to be prominent in 5 of 10 ulnar models. The supinator crest was 43.59 ± 13.28 mm long, and the supinator tubercle lateral extrusion was 5.60 ± 0.90 mm. The distance between the radial head junction and the supinator tubercle was found to be 15 ± 2.37 mm, and the distance from the supinator crest at the radial head junction to the posterior cortex was 10.25 ± 2.07 mm.

Conclusion: The supinator tubercle is frequently not prominent or easily recognizable. Its relationship to other structures is of value. The proximal border of the radial head, residing 15 mm proximal to the most predictable location of the supinator tubercle, is a useful landmark when drilling tunnels during LUCL reconstructions.

Clinical relevance: Results of this study may aid proper anatomic LUCL reconstruction.

No MeSH data available.


Related in: MedlinePlus