3D computational anatomy of the scaphoid and its waist for use in fracture treatment.

Autor: Ahrend MD; Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany. mahrend@bgu-tuebingen.de.; AO Research Institute Davos, Clavadelerstr. 8, Davos, Switzerland. mahrend@bgu-tuebingen.de., Teunis T; Plastic Surgery Department, University Medical Center Utrecht, Heidelberglaan 100, 3584, CX, Utrecht, The Netherlands., Noser H; AO Research Institute Davos, Clavadelerstr. 8, Davos, Switzerland., Schmidutz F; Department of Traumatology and Reconstructive Surgery, BG Trauma Center Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstr. 95, 72076, Tübingen, Germany.; AO Research Institute Davos, Clavadelerstr. 8, Davos, Switzerland.; Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University of Munich (LMU), Marchioninistr. 15, 81377, Munich, Germany., Richards G; AO Research Institute Davos, Clavadelerstr. 8, Davos, Switzerland., Gueorguiev B; AO Research Institute Davos, Clavadelerstr. 8, Davos, Switzerland., Kamer L; AO Research Institute Davos, Clavadelerstr. 8, Davos, Switzerland.
Jazyk: angličtina
Zdroj: Journal of orthopaedic surgery and research [J Orthop Surg Res] 2021 Mar 24; Vol. 16 (1), pp. 216. Date of Electronic Publication: 2021 Mar 24.
DOI: 10.1186/s13018-021-02330-8
Abstrakt: Background: A detailed understanding of scaphoid anatomy helps anatomic fracture reduction, and optimal screw position. Therefore, we analysed (1) the size and shape variations of the cartilage and osseous surface, (2) the distribution of volumetric bone mineral density (vBMD) and (3) if the vBMD values differ between a peripheral and a central screw pathway?
Methods: Forty-three fresh frozen hand specimens (17 females, 26 males) were analysed with high-resolution peripheral quantitative computed tomography (HR-pQCT) and dissected to compute a 3D-statistical osseous and cartilage surface model and a 3D-averaged vBMD model of the scaphoid. 3D patterns were analysed using principal component analysis (PCA). vBMD was analysed via averaging HR-pQCT grey values and virtual bone probing along a central and peripheral pathway.
Results: (1) PCA displayed most notable variation in length ranging from 1.7 cm (- 2SD) to 2.6 cm (mean) and 3.7 cm (+ 2SD) associated with differences of the width and configuration of the dorsal surface (curved and narrow (4 mm) to a wider width (9 mm)). (2) High vBMD was located in the peripheral zone. Lowest vBMD was observed in the centre and waist. (3) Virtual probing along a peripheral pathway near to the cartilage surfaces for the capitate and lunate allowed the center region to be bypassed, resulting in increased vBMD compared to a central pathway.
Conclusion: High anatomical variations regarding the osseous and cartilage surfaces were associated with three distinct concentrically arranged zones with notable different vBMD. The complex scaphoid anatomy with its waist might alter the strategy of fracture fixation, education and research.
Databáze: MEDLINE
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