Computer assisted surgery of the distal humerus can employ contralateral images for pre-operative planning, registration, and surgical intervention

• Published in: Journal of shoulder and elbow surgery Vol. 18; no. 3; pp. 469 - 477
• Main Authors: McDonald, Colin P., PhD, Peters, Terry M., PhD, King, Graham J.W., MD, Johnson, James A., PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.05.2009; Elsevier
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Cadaver; Diseases of the osteoarticular system; Elbow Joint - anatomy & histology; Elbow Joint - diagnostic imaging; Elbow Joint - surgery; Female; Humans; Humerus - anatomy & histology; Humerus - diagnostic imaging; Humerus - surgery; Male; Medical sciences; Middle Aged; Orthopedic Procedures - methods; Orthopedics; Planning Techniques; Postoperative Care; Preoperative Care; Radiographic Image Interpretation, Computer-Assisted; Risk Factors; Sensitivity and Specificity; Surgery, Computer-Assisted - methods; Tomography, X-Ray Computed; Planning; Contralateral; Humerus; Computer-assisted surgery; Rheumatology
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2009.01.028

Background Bone loss at the distal humerus can lead to errors in the identification of the elbow's flexion-extension axis. Referencing the anatomy of the contralateral (uninjured) elbow may prove beneficial in accurately defining this axis. The objective of this study was to compare distal humeral morphology between paired specimens and determine whether geometric differences exist. Methods Medical CT images of 25 paired, dry cadaveric, distal humeri were acquired and a range of anatomic characteristics were measured, following registration of each pair to a common coordinate system. Results The anthropometric features of the distal humerus were similar from side-to-side, with differences on the order of 1.0° and 0.5 mm. Conclusions Preoperative imaging of the contralateral normal elbow may be employed in patients with peri-articular bone loss, where referencing anatomic landmarks of the injured side is not possible. Clinical relevance Using the contralateral anatomy, a more accurate implant alignment may be achieved when bone loss is sufficiently severe that referencing anatomic landmarks of the injured side is not possible.