Computed Tomography Analysis of the Radial Notch of the Ulna

© 2019 American Society for Surgery of the Hand Purpose: The anatomy of the radial head and capitellum has been extensively studied; however, the anatomy of the radial notch of the ulna (RNU) has received little attention. This imaging-based anatomic study characterizes the morphology of the RNU. Methods: Ninety-eight cadaveric arms (57 male, 72 ± 14 y) were imaged with computed tomography, and 3-dimensional reconstructions of the proximal ulna were constructed. The anteroposterior and proximal-distal dimensions of the RNU as well as the radius of curvature at standardized levels were measured in 2-mm increments. The orientation of the RNU was also determined. Results: The proximal-distal and anteroposterior dimensions of the RNU were 12 ± 2 mm (range, 7–16 mm) and 18 ± 3 mm (range, 12–24 mm), respectively. The average radius of curvature of the RNU was 15 ± 0 mm (range, 15–16 mm). The radius of curvature did not change significantly when comparing the proximal and distal aspect of the RNU. The RNU was rotated 33° ± 2° (range, 31° to 38°) externally relative to the transverse plane of the ulna. The average depth of the RNU at its deepest point was 2.2 ± 0.4 mm (range, 1.5–2.7 mm). The depth decreased from proximal to distal, being most shallow distally. The depth changed by an increase of the radius of curvature, as well as by rotation in the frontal plane. Conclusions: The RNU anatomy was variable, generally extending laterally from proximal to distal. This suggests that a radial head implant should taper from proximal to distal to optimize contact at the RNU. Clinical relevance: The present study investigates the detailed anatomy of the radial notch of the ulna using computed tomography scans. The data might help improve the design of prosthetic components