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the preshaped olecranon plate that was curved in both planes ( " plate c " ) was placed on the dorsal surface of the " model " ulna. the two small spurs found on the proximal tip of the plate were impacted into the olecranon. a good plate-to-bone fit in the coronal plane. A slight increase in the varus angulation is necessary to reach the average of the bone sample. b good plate-to-bone fit in the sagittal plane. the proximal tip of the plate did not extend above the MAPSS of the olecranon
Source publication
To define the optimum design of the anatomical preshaped olecranon plate.
The geometry of the proximal ulna was studied in 200 paired Caucasian ulnae, using a digital caliper and goniometer. Gender and side differences were analyzed. Results were compared with the corresponding geometrical parameters of three olecranon plates with different contour...
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Rationale
Elbow injury in children by improper treatment or a delay of more than 3 weeks could lead to old unreduced Monteggia fracture, which are difficult to manage. Conservative or normal surgical methods usually fail.
Patient concerns
Herein, we present a 6-year-old boy with sustaining injury approximately 1 month to his left elbow. Activity i...
Objective
The treatment of missed Monteggia fracture remains a challenge, despite the various surgical methods described. The purpose of this study was to explore a new surgical technique utilizing external fixator‐assisted ulnar osteotomy and to assess the surgical results in a case series.
Methods
Thirteen patients with missed Monteggia fracture...
Purpose
The aims of this study were to review our cases of missed Monteggia fracture treated by open reduction of the radial head with or without ulnar osteotomy and to investigate the indications for open reduction alone in surgical treatment of missed Monteggia fracture.
Materials and Methods
We retrospectively reviewed 22 patients who presented...
Introduction:
The eponym "Monteggia fracture" includes various patterns of complex fracture-dislocations of the proximal ulna and radius, which are not well defined yet. They are frequently described as Monteggia-like lesions or Monteggia equivalent injuries. Until today, these injury patterns have been reported rarely. The objective of this retro...
Citations
... Totlis et al. 10 The mean UL, PDVA, and DDVA obtained in this study may serve as reference values in adjusting the length of dorsal plates and intramedullary screws in the Turkish population. In addition, the mean WPVA, DAPB, and DPIB values might guide orthopedic surgeons to adjust the length of the screws to be performed to the point where the VA is located and determine the depth of the screw in that population. ...
... 18 Beşer et al. 5 recorded that the mean VA was 9.3° in 50 adult normal ulnae. Totlis et al. 10 20 examined computed tomography images of 59 ulnas and reported that the mean VA was 10.5° (9.8°-11.1°). Aydın Kabakçı 16 examined 62 ulnae and noted that the mean VA was 9.20°±1.85°. ...
... Totlis et al. 10 17 reported that the average PUDA was 176°±1° (it is understood that it is equivalent in other studies at 4.0°±1°). Savakkanavar and Babu 21 studied bilateral elbow radiographs of 60 patients and reported that the PUDA was meanly 5.6° on the right side and 5.1° on the left side. ...
Objective: The proximal ulna has a complex and unique architectural anatomy, therefore, its fractures are difficult to manage. This paper aimed to evaluate proximal ulnar angu-lations that contribute to the fixation and restoration of proximal ulna fractures in the Turkish population. Materials and Methods: This study was performed on 107 Turkish adult ulnae (55 right, 52 left) whose age and sex were unknown. The ulnar length (UL), proximal distance of varus angulation (PDVA), and widths at the point of varus angulation were measured with a digital caliper. The proximal ulna torsion angle (PUTA), varus angulation (VA), proximal ulna dorsal angulation (PUDA), articular angle (AA), and olecranon-diaphysis angle (ODA) were measured with a goniometer. The statistical analysis was carried out at the SPSS 21.0 program (IBM Corporation, Armonk, NY, USA). Results: The median UL was 251.97 mm (minimum: 196.84-maximum: 497.76 mm), median PDVA was 82.7 mm (minimum: 16.21-maximum: 108.62 mm), mean total width was 15.04±1.84 mm, mean posterior-interosseous width was 13.72±2.37 mm and mean posterior-anterior width was 15.15±1.93 mm. The mean PUTA was 27.10°±9.04°, the median VA was 14° (minimum: 5°-maximum: 23°), the median PUDA was 8° (minimum:-3°-maximum: 20°), the median AA was 25° (minimum: 19°-maximum: 39°), and the mean ODA was 17.39°±5.33°. A moderate negative correlation was detected between the PUDA and ODA (rs=-0.50, p<0.001). Conclusion: The mean proximal ulnar angulations in this study can be beneficial during surgery for the fixation of proximal ulna fractures. This study revealed the correlation between proximal ulnar angulations in the Turkish population.
... Proximal ulna dorsal angulation (PUDA) is the intersection angle of lines drawn along the dorsal flat surface of the olecranon and the dorsal prominence of the ulnar shaft. This angle typically measures typically between 4.3 and 8.5° in adults [1,5,12,15,22,27]. Olecranon tip-to-apex distance (TTA) is the distance measured on the line tangent to dorsal flat surface of the olecranon, between proximal tip of olecranon and place of proximal ulna angulation [6,15]. ...
... Olecranon tip-to-apex distance (TTA) is the distance measured on the line tangent to dorsal flat surface of the olecranon, between proximal tip of olecranon and place of proximal ulna angulation [6,15]. TTA was reported to be between 47.0 mm and 86.3 mm in adults [2,15,22]. Due to radioulnar functional interplay, restoring native PUDA and TTA after a proximal ulna fracture is crucial for posttraumatic elbow function [2,14,16,20]. Sandman et al. reported that five degrees of proximal ulna malreduction may result in radiohumeral joint subluxation [16]. ...
... While multiple authors measured PUDA [1,5,12,15,22,27] and TTA [2,15,22] in adults, due to authors knowledge PUDA and TTA were not described in various children and adolescents age groups. Therefore, the aim of the study was to measure PUDA and TTA in different children and adolescents age groups to aid surgeons with data for reduction and fixation of proximal ulna fractures. ...
Purpose
To measure proximal ulna dorsal angulation (PUDA) and olecranon tip-to-apex distance (TTA) in pediatric population to aid surgeons with data for proximal ulna fractures fixation.
Methods
Retrospective review of the hospital radiographic database. All elbow radiographs were identified and after implementing exclusion criteria, included were 95 patients aged 0–10; 53 patients aged 11–14; and 53 patients aged 15–18. PUDA was defined as the angle between lines placed on the “flat spot” of the olecranon and the dorsal edge of the ulnar shaft and TTA as the distance between the tip of the olecranon to the apex of angulation. Two evaluators performed measurements independently.
Results
In age group 0–10, mean PUDA was 7.53°, range 3.8–13.7, 95% CI 7.16–7.91, while mean TTA was 22.04 mm, range 8.8–50.5, 95% CI 19.92–24.17. In age group 11–14, mean PUDA was 4.99°, range 2.5–9.3, 95% CI (4.61–5.37), while mean TTA was 37.41 mm, range 16.5–66.6, 95% CI (34.91–39.90). In age group 15–18, mean PUDA was 5.18°, range 2.9–8.1, 95% CI (4.75–5.61), while mean TTA was 43.79 mm, range 24.5–79.4, 95% CI (41.38–46.19). PUDA was negatively correlated with age (r = − 0.56, p < 0.001), while TTA was positively correlated with age (r = 0.77, p < 0.001). Reliability levels of 0.81–1 or 0.61–0.80 were achieved for most of intra- and inter-rater reliabilities besides two levels of 0.41–60 and one of 0.21–0.40.
Conclusion
The main study finding is that in most cases mean age-group values may serve as a template for proximal ulna fixation. There are some cases in which X-ray of contralateral elbow may provide surgeon with a better template.
Level of evidence
II.
... The majority of previous studies illustrated the significant morphologic variances putting difficulty on a good match between anatomic plates and proximal ulna [2,11,19,[21][22][23]. Clinically, the ulnar shaft plates need to be bent to correctly fit the ulna and restore forearm rotation, indicating the straight anatomic plates would not suit all the proximal ulna [13,19], which was consistent with our results. ...
... Automatic preshaped plants are increasingly selected for the stabilization of sophisticated fractures such as comminuted olecranon fractures, terrible triad injuries, and Monteggia fractures [14,19,23,24]. Clinically, on many occasions, these "automatic preshaped implants" do not fit the proximal ulna. ...
Purpose
To perform quantitative measurements of the anatomic morphology of the proximal ulna and establish the morphologic references based on Chinese for the surgical protocol and implant design.
Methods
The computed tomography data of 156 upper extremities were involved in this study. The ulna model was reconstructed in Mimics. Ten distance and 6 angle parameters were measured by 4 independent investigators with a new quantitative measurement method. The intraclass correlation coefficient was used to evaluate the measuring reliability. Gender and side differences of measured parameters were evaluated.
Results
Measurements showed a mean coronoid height of 15 mm, which was 42% of ulnar height with gender-specific differences (mean 16 mm in men and 14 mm in women, P < 0.001). A mean unsupported anteromedial facet width of 8 mm was 61% of the coronoid anteromedial facet. A larger opening angle correlates to a larger olecranon-diaphysis angle (P < 0.001) and larger coronoid height (P = 0.001). A mean proximal ulna dorsal angulation of 4.7° is present in 80% of models at an average of 52 mm distal to olecranon tip. The average proximal ulna varus angulation was 16° at a mean of 74 mm distal to the olecranon tip. Morphological features between the left and right sides were highly consistent. The ICC was between 0.789 and 0.978 for inter-observer and between 0.696 and 0.997 for intra-observer reliability.
Conclusions
The proximal ulna features variable morphology but minor side differences among individuals. Over half of the anteromedial facet was not supported by the proximal ulnar diaphysis, making the coronoid vulnerable to elbow trauma. Preconditioning or customized design of the ulnar plate in the clinical setting with the help of contralateral morphology may be a good choice.
... Ancak deplase olmuş kırıklarda cerrahi tedavi ön plana çıkmaktadır (3,4). Deplase kırık paterni olan olgularda, gergi bandı telleri, ulna'nın proksimal bölümü plakları ve intramedüller vidalar kullanılarak fiksasyon sağlanabilir (3,5). Ulna'nın proksimal bölümü'nün şekli, kırıkların stabilizasyonunu ve cerrahi sonrası fonksiyonların rehabilitasyonunu etkiler (6). ...
... Redüksiyonun tam olarak gerçekleştirilemediği ufak parçalı kırıklarda ise uygun bir plak yardımı ile anatomik yapılanma desteklenebilir. Plak kullanımının gerektiği durumlarda ise ulna'nın proksimal bölümünün yapısının detaylı bilinmesi önemlidir (5). Bu sebeple, laboratuvarımızda yer alan ulna'ların proksimal kısımlarına ait morfometrik verilerin ve ulna'nın proksimal bölümünün açılanmalarını detaylı bir şekilde değerlendirerek verilerin literatüre katkı sağlamasını plandığımız bu çalışma tasarlanmıştır. ...
Amaç: Ulna’nın proksimal bölümü'nün şekli, kırıkların stabilizasyonunu ve cerrahi sonrası fonksiyonların rehabilitasyonunu etkileyen unsurlardan birisidir. Redüksiyon sırasında normal anatomik yapılanma sağlanamaz ise bu durum eklemin çıkıklarına, artritine ve fonksiyon kaybına neden olabilir. Redüksiyonun tam olarak gerçekleştirilemediği ufak parçalı kırıklarda ise uygun bir plak yardımı ile anatomik yapılanma desteklenebilir. Plak kullanımının gerektiği durumlarda ise ulna’nın proksimal bölümü yapısının detaylı bilinmesi önemlidir.Materyal ve metod: Bu çalışma, Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, Anatomi Anabilim Dalı’na ait kemik koleksiyonundaki 62 (cinsiyetleri belirsiz, 26 sağ ve 36 sol ulna) adet ulna üzerinde gerçekleştirildi. Çalışmamızda ulna'nın proksimal bölümü'ne ait uzunluk ve genişlik ölçümleri ile birlikte açı ölçümleri gerçekleştirilmiştir.Bulgular: Çalışmamızda toplam ulna uzunluğu (UU) ortalama 24.59±2.00 cm olarak belirlenmiştir. Inc. radialis yükseklik (IRY) ve genişlik (IRG) ölçümleri tüm ulna’larda ortalama olarak sırasıyla 9.69±1.64 mm ve 15.22±2.18 mm olarak belirlenmiştir. Inc. trochlearis derinliğinin (ITD) ise 7.30 ile 13.70 mm (ortalama 10.15 mm) arasında değişkenlik gösterdiği belirlenmiştir. Tüm ulna’larda ortalama ulna’nın proksimal bölümü torsiyon açısı (PUTA), varus açısı (VA), artiküler açı (AA), ulna’nın proksimal bölümü dorsal açısı (PUDA), tüberkül açısı (TA), olecranon-diyafiz açısı (ODA) sırasıyla 13.40±1.230, 9.20±1.850, 20.37±1.020, 5.85±2.210, 18.99±0.830, 15.49±3.100 olarak belirlenmiştir.Sonuç: Bireysel farklılıkların göz önüne alınarak tasarlandığı implant ve protezler dirsek eklemindeki uyumun başarı oranını arttırmakta ve eklemin fonksiyonunu düzgün olarak yerine getirilmesini sağlamak-tadır.
... Also, the presence of intact radial head or fixed fracture of radial head retaining the lateral column support and maintain the secondary constraint of elbow stability helps to support an optimal fixation by tension band wiring without any collapse. Such a technique is useful in ferent studies [10][11][12][13]. In our study, PUDA was 6.3° ± 2.4° which was similar to the previous studies. ...
Transolecranon fracture-dislocations are a result of high-energy trauma, caused due to axial loading of the flexed forearm, with associated anterior dislocation of the ulna with respect to the distal humerus. The usual management of these comminuted and unstable fractures is by using locking compression plates via the dorsal approach. However, plating in cases of poor soft tissue coverage and open wounds can be precarious. In this study, we aimed to evaluate outcomes of cerclage wiring in the management of comminuted trans-olecranon fracture-dis-locations in such scenario. A total of seven patients diagnosed with trans-olecranon fracture-dislocation with poor soft tissue coverage who underwent cerclage wiring were included in the study. The aim was to realign the proximal portion of the olecranon to the trochlea and restore the normal ulnohumeral articular relationships accomplished by the anatomical reconstruction of the greater sigmoid notch. Reconstruction of the proximal ulna was started from the distal to the proximal direction so as to convert an unstable fracture into a stable one. After the reduction of the proximal fragment, two long 2 mm K wires were inserted from the tip of the olecranon into the intramedullary canal (with at least 1 wire passed subchondrally), and later cerclage was done. Postoperatively the patient was immobilized for a duration of two weeks and was later started on active assisted mobilization of the elbow. All patients showed fair-to-excellent outcome on the Mayo elbow performance score (MEPS) at the final follow-up (five patients had an excellent score, one had a good score, and one had a fair score). At the final follow-up, the mean extension, flexion, pronation and supination were-20, 117.14, 82.85 and 78.57 degrees respectively. The key components of such management are the restoration of articular congruity, including continuity of the sigmoid cavity, ulnar length, and early initiation of active elbow movements to avoid joint stiffness. Optimal functional results can be achieved with K wire and cerclage when a stable anatomic reconstruction is accomplished, as a feasible alternative to plating.
... 28 The screw must be placed toward the radial side of the ulna to negotiate the radial bow which, in the coronal plane is between 6.2 and 8.5 (range 1.7e21.2) and located between 5.7 and 11.7 cm from the most proximal tip of the olecranon. 29,30 Therefore, we use the "rule of 8's" when teaching this technique, After the ulnar nerve is protected (blue vessiloop), the fracture can be assessed by mobilizing the triceps from the posterior aspect of the humerus and can utilize the defect in the triceps created by the fracture (dashed line) (A). A periosteal elevator is introduced below the triceps from medial to lateral to elevate and protect the triceps (B). ...
Distal humeral fractures in adults are challenging injuries. They often require surgical intervention in form of internal fixation or total elbow arthroplasty which is being increasingly used in physiologically elderly patients with comminuted fractures. Careful preoperative evaluation including type of fracture, quality of bone, pre-existing condtions and functional demand help in deciding optimal treatment. CT scans including 2D and 3D reconstuctions are almost mandatory in proper planning of the surgical treatment. In most cases with a healthy physiologically young patient, ORIF is the treatment of choice. Biomechanical studies have shown that parallel plating resists rotational deformity to a greater degree than 90/90 plating allowing supracondylar union. Accurate realignment of articular frangments and compression at the supracondylar area is key to the success of the internal fixation. Main cause of failure of fixation is the nonunion or malunion in the supracondylar area. The principles described by O’Driscoll et. al. allow for rigid fixation of the distal articular fragments and compression at the supracondylar level which is vital to healing and the prevention of hardware failure, and nonunion. Olecranon osteotomy improves the expodure of distal humeral articular surface but has its own share of problems and should be avoided if possible. Irritation of ulnar nerve is a common complication so it should be isolated, kept under vision throughout and if necessary, transposed anteiriorly. Nonunion or malunion of supracondylar fractures can be treated by revision ORIF or total elbow arthroplasty (TEA). Supracondylar shortening, bone grafting and contracture release are important elements of treatment of nonunions.
In unreconstructable distal humerus fractures, where open reduction and internal fixation is not possible due to the small size of the fragments, severe comminution and/or poor bone quality, TEA is the treatment of choice. Triceps can be left intact as the excision of fractured fragments usually provide enough space to carry out the operation. Sometimes, the decision to perform TEA is only made after exposing the fracture so the surgeon should be comfortable in performing TEA if ORIF is not possible; and necessary instruments and implants should be available on the shelf. In spite of satisfactory outcome, overall complication rate after TEA remains high and makes surgical efficiency and technical competence of utmost importance
... The proximal ulna has a complex anatomy. It has been shown to have a dorsal angulation in sagittal plane (PUDA), 18 Rouleau et al. 2 showed that the PUDA (Fig. 6) was present in 96% of the radiographs of Caucasian cadavers (n ¼ 50). The average PUDA was reported as 5.7 (range, 0.2 e11.8 ; SD, 2.4 ) and was located at an average of 47 mm distal to the olecranon tip. ...
... a varus angulation in coronal plane and a torsional angulation in the axial plane. Restoring the anatomy of this complex 3-dimensional angulation of the ulna is important especially in fixation of Monteggia or transolecranon fracture dislocation.18 ...
The anatomy of the elbow joint had been studied extensively over the last 2 decades. The increased understanding of the anatomy and contribution of the anatomical structures to the elbow biomechanics had enabled surgeons to improve the results of surgical reconstruction and fracture fixation. This review articles intend to summarise the salient functional and clinical anatomical and relevant biomechanical data that had been published recently.
... Important drawbacks are large soft tissue exposure, compromised blood supply of the fracture fragments and bulky osteosynthetic material, which forces to implant removal in a high number of cases [4,[7][8][9]. Even precontoured anatomic plates cannot address the wide range of anatomic variations of the proximal ulna sufficiently [10,11]. Some studies show high complication rates especially for tension band wiring at the proximal ulna, such as cutaneous complications, secondary fracture displacement and fracture non-union [4,12]. ...
... The main reason for this is that the forearm is regarded as a joint and anatomical reduction is needed for an optimal functional result. Although anatomically preshaped implants are available, restoration of the complex anatomical shape of the proximal ulna is a difficult surgical challenge [10,11,19]. ...
Purpose
Proximal ulna fractures are common injuries and frequently treated with angular stable plating. This surgical option shows good functional results. Relevant drawbacks such as large soft tissue exposure, compromised blood supply of fracture fragments and disturbing osteosynthetic material are described. The aim of this study was to compare a new locked proximal ulna nail with angular stable plating in a biomechanical testing setup for extraarticular proximal ulna fractures.
Methods
Ten pairs of sawbones with a Jupiter type IIB proximal ulna fracture (OTA 2U1A3.1) were tested after osteosynthesis with the mentioned implants in a servo-pneumatic testing machine. The testing setup simulates physiological joint motion (0°–90°) under cyclic loading (30–300 N). Primary stability and loosening of both constructs were quantified using micromotion video-analysis after 608 test cycles.
Results
The micromotion analysis showed significantly higher primary stability of the locked nail (0.29 ± 0.13 mm) compared to the angular stable plate (0.97 ± 0.30 mm, p < 0.001). Both implants showed a low amount of loosening after completion of the test cycles. The construct with the locked nail (0.08 ± 0.06 mm) showed significantly lower dislocation of the fragments measured at the anterior cortex (plate 0.24 ± 0.13 mm, p < 0.001).
Conclusion
Nailing of proximal ulna fractures shows significantly higher primary stability and lower loosening compared to angular stable plating in our testing setup.
... The anatomy of the proximal ulna has been widely studied in the setting of reconstructive as well as replacement surgery [16][17][18]. Simple radiological landmarks, such as the posterior cortex of proximal ulna and tips of olecranon and coronoid processes, have been used to better describe the elbow anatomy in its complexity [13,17]. ...
Introduction
The coronoid process plays a key-role in preserving elbow stability. Currently, there are no radiographic indexes conceived to assess the intrinsic elbow stability and the joint congruency. The aim of this study is to present new radiological parameters, which will help assess the intrinsic stability of the ulnohumeral joint and to define normal values of these indexes in a normal, healthy population.
Methods
Four independent observers (two orthopaedic surgeons and two radiologists) selected lateral view X-rays of subjects with no history of upper limb disease or surgery. The following radiographic indexes were defined: trochlear depth index (TDI); anterior coverage index (ACI); posterior coverage index (PCI); olecranon–coronoid angle (OCA); radiographic coverage angle (RCA). Inter-observer and intra-observer reproducibility were assessed for each index.
Results
126 subjects were included. Standardized lateral elbow radiographs (62 left and 64 right elbows) were obtained and analysed. The mean TDI was 0.46 ± 0.06 (0.3–1.6), the mean ACI was 2.0 ± 0.2 (1.6–3.1) and the mean PCI was 1.3 ± 0.1 (1.0–1.9). The mean RCA was 179.6 ± 8.3° (normalized RCA: 49.9 ± 2.3%) and the mean OCA was 24.6 ± 3.7°. The indexes had a high-grade of inter-observer and intra-observer reliability for each of the four observers. Significantly higher values were found for males for TDI, ACI, PCI and RCA.
Conclusion
The novel radiological parameters described are simple, reliable and easily reproducible. These features make them a promising tool for radiographic evaluation both for orthopaedic surgeons and for radiologists in the emergency department setting or during outpatient services.
Level of evidence
Basic Science Study (Case Series).
Clinical relevance
The novel radiological parameters described are reliable, easily reproducible and become handy for orthopaedic surgeons as well as radiologists in daily clinical practice.
... Kırık uçları yer değiştirmemiş ise önkolu hareketsiz hale getiren ve dirsek eklem hareketlerini önleyen basit bir atel kırık rehabilitasyonu için yeterli olabilmektedir. Ancak Monteggia tipi kırıklar ve eklem içi olecranon kırıkları cerrahi olarak açık redüksiyon ve internal fiksasyon ile tedavi edilebilir (2,3). Kırık veya olecranon osteotomisinden sonra anatominin doğru yapılandırılamaması, eklem subluksasyonuna, erken artrit ve işlev kaybına neden olabilir (4). ...
... Kırık ufalanması nedeniyle tam anatomik redüksiyon mümkün olmadığında, kemik parçaları plağa uyacak şekilde ayarlanabilir. Bu gibi durumlarda, parçaların normal ulna ile aynı kontura sahip bir plakaya mükemmel şekilde oturmasının, proksimal ulnanın karmaşık geometrisini eski haline getirmek için ideal olacağı ifade edilmiştir (3). Yoğun günlük aktiviteler, uygun olmayan implant tasarımı ve implantların yanlış hizalanması gibi çeşitli faktörler implant bileşenlerinin gevşemesine neden olabilir (5). ...
... Ticari olarak üretilen implantlar çoğunlukla proksimal ulna'nın dorsal yüzeyi ile uyumludur. Ancak implantlar proksimal ulna mimarisine tam olarak uymuyorsa, malzeme bileşikleri nedeniyle bunları kolayca bükmek mümkün değildir (3). Bu implantların proksimal ulna anatomisine uygun olarak tasarlanması fonksiyonel iyileşmeyi etkiler (2). ...
Amaç Literatürde az yer alan torsiyon açısı da dahil olmak üzere proksimal ulna’ya ait diğer bazı morfometrik verilerin elde edilmesi amaçlandı. Gereç ve Yöntem Bu çalışmada Anatomi Ana Bilim Dalı laboratuvarında bulunan 25 ulna (11 sol, 14 sağ) kullanıldı. Proksimal ulna'ya ait 8 morfometrik parametre ölçüldü. Tüm kuru kemikler bir cetvel eşliğinde fotoğraflandı ve bilgisayara aktarıldı. Daha sonra Image-J analiz programı yardımıyla morfometrik ölçümler yapıldı. Bulgular Ortalama ulna uzunluğu 251,02±16.23 mm ve ortalama incisura trochlearis hariç ulna uzunluğu 223,49±15.52 mm bulundu. Ortalama incisura radialis genişliği 18,5±3.38 mm, ortalama incisura radialis yüksekliği 12,09±1.70 mm ve ortalama incisura trochlearis derinliği 11,57±1.73 mm bulundu. Ortalama torsiyon açısı, dorsal açılanma ve varus açısı sırasıyla 14,64º±8.36º; 5,94º±2.01º; 12,48º±2.425º olarak hesaplandı. Hiçbir parametrede taraflar arası karşılaştırmada istatistiksel olarak anlamlı fark bulunmadı. Sonuç Proksimal ulna’nın anatomik şekli, humeroulnar artroplastide kullanılan implantlar için özel zorluklar oluşturmaktadır. Bu çalışmadaki tüm parametrelerde sağ ve sol taraflar arasında fark olmaması, uygun protez tasarımında karşı taraf ulna’nın bilgisinden yararlanılabileceğini düşündürmektedir. Ayrıca bu çalışmanın sonuçları, adli ve antropolojik araştırmalarda ulna boyutlarına ilişkin veriler sağlayacaktır.
