Anatomic Investigation of Commonly Used Landmarks for Evaluating Rotation During Forearm Fracture Reduction

Conclusions:
Our findings suggest that using the bicipital tuberosity and the radial styloid to assess intraoperative rotation of the radius on anteroposterior radiographs may be of limited value; the landmarks were not generally 180° apart. Although the rotational positions of the coronoid process and the ulnar styloid were, on average, closer to 180°, surgeons should be aware of the wide range of normal anatomy as well as the inability to judge rotation by as much as 60°, even for an "ideal" ulna.

Clinical Relevance:
This study, to our knowledge, represents the first anatomic investigation of the rotational profiles between the osseous landmarks used to assess forearm rotation after fracture. We recommend that surgeons first image the bicipital tuberosity at its largest profile, supinate the arm 20°, and confirm that the radial styloid is at its largest profile. The ulna can then be assessed to support the lack of rotational deformity in the forearm.

Source: JBJS - July 5, 2016 Category: Orthopaedics Authors: Weinberg, D. S., Park, P. J., Boden, K. A., Malone, K. J., Cooperman, D. R., Liu, R. W. Tags: Basic Science, Pediatrics, Trauma Scientific Articles Source Type: research