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Surgical and Radiologic Anatomy

, Volume 41, Issue 4, pp 423–429 | Cite as

The relationship between the morphological axis and the kinematic axis of the proximal radius

  • Satoshi OkiEmail author
  • Naoto Inaba
  • Noboru Matsumura
  • Takuji Iwamoto
  • Yoshitake Yamada
  • Masahiro Jinzaki
  • Takeo Nagura
Original Article
  • 56 Downloads

Abstract

Purpose

Surgical procedures for impaired forearm rotation such as for chronic radial head dislocation remain controversial. We hypothesized that the morphological axis of the proximal radius is important for stable forearm rotation, and we aimed to clarify the relationship between the morphological axis and the kinematic axis of the proximal radius using four-dimensional computed tomography (4DCT).

Methods

Ten healthy volunteers were enrolled. Four-dimensional CT of the dominant forearm during supination and pronation was obtained. The rotation axis of forearm rotation was calculated from all frames during supination and pronation. The principle axis of inertia, which represents the most stable rotation axis of a rigid body, was calculated for the proximal radius by extending its surface data incrementally by 1% from the proximal end. The angle between the kinematic rotation axis and the morphological rotation axis of each length was calculated.

Results

The rotation axis of the forearm was positioned on the radial head 0.0 mm radial and 0.4 mm posterior to the center of the radial head proximally and 2.0 mm radial and 1.2 mm volar to the fovea of the ulnar head distally. The principle axis at 15.9% of the length of the proximal radius coincided with the forearm rotation axis (kinematic axis). Individual differences were very small (SD 1.4%).

Conclusion

Forearm rotation was based on the axis at 16% of the length of the proximal radius. This portion should be aligned in cases of severe morphological deformity of the radial head that cause “rattling motion” of the radial head after reduction procedures.

Keywords

Computed tomography Radius Rotation axis 4DCT 

Notes

Author contributions

SO: Data analysis, manuscript writing and management. NI, NM, TI and TN: Protocol development. MJ and YY: Protocol of 4DCT data acquisition.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Caravias DE (1957) Some observations on congenital dislocation of the head of the radius. J Bone Jt Surg Br 39-B:86–90CrossRefGoogle Scholar
  2. 2.
    Chen HY, Wu KW, Dong ZR, Huang SC, Kuo KN, Wang TM (2018) The treatment of chronic radial head dislocation in Monteggia fracture without annular ligament reconstruction. Int Orthop 42:2165–2172.  https://doi.org/10.1007/s00264-018-3943-6 CrossRefGoogle Scholar
  3. 3.
    Futami T, Tsukamoto Y, Fujita T (1992) Rotation osteotomy for dislocation of the radial head. 6 cases followed for 7 (3–10) years. Acta Orthop Scand 63:455–456CrossRefGoogle Scholar
  4. 4.
    Gamage SS, Lasenby J (2002) New least squares solutions for estimating the average centre of rotation and the axis of rotation. J Biomech 35:87–93CrossRefGoogle Scholar
  5. 5.
    Gleeson AP, Beattie TF (1994) Monteggia fracture-dislocation in children. J Accid Emerg Med 11:192–194CrossRefGoogle Scholar
  6. 6.
    Goyal T, Arora SS, Banerjee S, Kandwal P (2015) Neglected Monteggia fracture dislocations in children: a systematic review. J Pediatr Orthop B 24:191–199.  https://doi.org/10.1097/BPB.0000000000000147 CrossRefGoogle Scholar
  7. 7.
    Hansen C, Rezzoug N, Gorce P, Venture G, Isableu B (2016) Sequence-dependent rotation axis changes and interaction torque use in overarm throwing. J Sports Sci 34:878–885.  https://doi.org/10.1080/02640414.2015.1076167 CrossRefGoogle Scholar
  8. 8.
    Isableu B, Rezzoug N, Mallet G, Bernardin D, Gorce P, Pagano CC (2009) Velocity-dependent changes of rotational axes in the non-visual control of unconstrained 3D arm motions. Neuroscience 164:1632–1647.  https://doi.org/10.1016/j.neuroscience.2009.08.065 CrossRefGoogle Scholar
  9. 9.
    Kim HT, Conjares JN, Suh JT, Yoo CI (2002) Chronic radial head dislocation in children, Part 1: pathologic changes preventing stable reduction and surgical correction. J Pediatr Orthop 22:583–590Google Scholar
  10. 10.
    Lloyd-Roberts GC, Bucknill TM (1977) Anterior dislocation of the radial head in children: aetiology, natural history and management. J Bone Jt Surg Br 59-B:402–407CrossRefGoogle Scholar
  11. 11.
    Miyake J, Moritomo H, Kataoka T, Murase T, Sugamoto K (2012) In vivo three-dimensional motion analysis of chronic radial head dislocations. Clin Orthop Relat Res 470:2746–2755.  https://doi.org/10.1007/s11999-012-2325-4 CrossRefGoogle Scholar
  12. 12.
    Murase T, Oka K, Moritomo H, Goto A, Yoshikawa H, Sugamoto K (2008) Three-dimensional corrective osteotomy of malunited fractures of the upper extremity with use of a computer simulation system. J Bone Jt Surg Am 90:2375–2389.  https://doi.org/10.2106/JBJS.G.01299 CrossRefGoogle Scholar
  13. 13.
    Nakamura K, Hirachi K, Uchiyama S, Takahara M, Minami A, Imaeda T, Kato H (2009) Long-term clinical and radiographic outcomes after open reduction for missed Monteggia fracture-dislocations in children. J Bone Jt Surg Am 91:1394–1404.  https://doi.org/10.2106/JBJS.H.00644 CrossRefGoogle Scholar
  14. 14.
    Nakamura T, Yabe Y, Horiuchi Y, Yamazaki N (1999) In vivo motion analysis of forearm rotation utilizing magnetic resonance imaging. Clin Biomech 14:315–320CrossRefGoogle Scholar
  15. 15.
    Oka K, Murase T, Moritomo H, Sugamoto K, Yoshikawa H (2010) Morphologic evaluation of chronic radial head dislocation: three-dimensional and quantitative analyses. Clin Orthop Relat Res 468:2410–2418.  https://doi.org/10.1007/s11999-010-1283-y CrossRefGoogle Scholar
  16. 16.
    Ring D, Jupiter JB, Waters PM (1998) Monteggia fractures in children and adults. J Am Acad Orthop Surg 6:215–224CrossRefGoogle Scholar
  17. 17.
    Rodgers WB, Waters PM, Hall JE (1996) Chronic Monteggia lesions in children. Complications and results of reconstruction. J Bone Jt Surg Am 78:1322–1329CrossRefGoogle Scholar
  18. 18.
    Stoll TM, Willis RB, Paterson DC (1992) Treatment of the missed Monteggia fracture in the child. J Bone Jt Surg Br 74:436–440CrossRefGoogle Scholar
  19. 19.
    Suzuki T, Seki A, Nakamura T, Ikegami H, Takayama S, Nakamura M, Matsumoto M, Sato K (2015) Re-dislocation after corrective osteotomy for chronic dislocation of the radial head in children. Bone Jt J 97-B:1582–1587.  https://doi.org/10.1302/0301-620X.97B11.36009 CrossRefGoogle Scholar
  20. 20.
    Tajima T, Yoshizu T (1995) Treatment of long-standing dislocation of the radial head in neglected Monteggia fractures. J Hand Surg Am 20:S91–S94CrossRefGoogle Scholar
  21. 21.
    Tay SC, van Riet R, Kazunari T, Koff MF, Amrami KK, An KN, Berger RA (2008) A method for in-vivo kinematic analysis of the forearm. J Biomech 41:56–62.  https://doi.org/10.1016/j.jbiomech.2007.07.019 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OrthopedicsKeio University School of MedicineTokyoJapan
  2. 2.Department of OrthopedicsSaiseikai Utsunomiya HospitalUtsunomiyaJapan
  3. 3.Department of RadiologyKeio University School of MedicineTokyoJapan
  4. 4.Department of BiomechanicsKeio University School of MedicineTokyoJapan

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