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The radiocapitellar synovial fold: a lateral anatomic landmark for sizing radial head arthroplasty.

Publication ,  Journal Article
Lampley, AJ; Brubacher, JW; Dekker, TJ; Richard, MJ; Garrigues, GE
Published in: J Shoulder Elbow Surg
September 2018

BACKGROUND: Successful radial head arthroplasty relies on reproduction of anatomy. We hypothesized that the radiocapitellar synovial fold could serve as a reference point in radial head prosthesis sizing. Our study aimed to define the relationship between the synovial fold and the radial head in elbows with and without lateral ulnar collateral ligament (LUCL) injury. MATERIALS AND METHODS: We performed magnetic resonance imaging evaluation of 34 elbows to determine the normal relationship between the radiocapitellar synovial fold and the radial head. Next, we used cadaveric dissections to evaluate the anatomic relationships with the LUCL intact and disrupted, as well as in the setting of sizing with a radial head prosthesis. The fold-to-radial head distance (FRHD) was measured on all images and analyzed to determine the relationship of the synovial fold and radial head. RESULTS: The FRHD in cadavers with an intact LUCL and native radial head measured an average of 1.5 mm proximal to the radial head. With the LUCL disrupted and a native radial head, the FRHD measured an average of 1.2 mm proximal to the radial head. The mean difference between the groups was 0.5 mm (P = .031), suggesting that the fold migrated distally in the cadavers with a disrupted LUCL. CONCLUSION: The radiocapitellar synovial fold may be a helpful landmark for radial head sizing. The synovial fold is always just proximal to the articular surface of the radial head. Using this information, the surgeon can prevent overlengthening as the implant should not be placed proximal to the fold.

Duke Scholars

Published In

J Shoulder Elbow Surg

DOI

EISSN

1532-6500

Publication Date

September 2018

Volume

27

Issue

9

Start / End Page

1686 / 1693

Location

United States

Related Subject Headings

  • Young Adult
  • Radius
  • Orthopedics
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Joint Capsule
  • Humans
  • Female
  • Epiphyses
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lampley, A. J., Brubacher, J. W., Dekker, T. J., Richard, M. J., & Garrigues, G. E. (2018). The radiocapitellar synovial fold: a lateral anatomic landmark for sizing radial head arthroplasty. J Shoulder Elbow Surg, 27(9), 1686–1693. https://doi.org/10.1016/j.jse.2018.02.070
Lampley, Alexander J., Jacob W. Brubacher, Travis J. Dekker, Marc J. Richard, and Grant E. Garrigues. “The radiocapitellar synovial fold: a lateral anatomic landmark for sizing radial head arthroplasty.J Shoulder Elbow Surg 27, no. 9 (September 2018): 1686–93. https://doi.org/10.1016/j.jse.2018.02.070.
Lampley AJ, Brubacher JW, Dekker TJ, Richard MJ, Garrigues GE. The radiocapitellar synovial fold: a lateral anatomic landmark for sizing radial head arthroplasty. J Shoulder Elbow Surg. 2018 Sep;27(9):1686–93.
Lampley, Alexander J., et al. “The radiocapitellar synovial fold: a lateral anatomic landmark for sizing radial head arthroplasty.J Shoulder Elbow Surg, vol. 27, no. 9, Sept. 2018, pp. 1686–93. Pubmed, doi:10.1016/j.jse.2018.02.070.
Lampley AJ, Brubacher JW, Dekker TJ, Richard MJ, Garrigues GE. The radiocapitellar synovial fold: a lateral anatomic landmark for sizing radial head arthroplasty. J Shoulder Elbow Surg. 2018 Sep;27(9):1686–1693.
Journal cover image

Published In

J Shoulder Elbow Surg

DOI

EISSN

1532-6500

Publication Date

September 2018

Volume

27

Issue

9

Start / End Page

1686 / 1693

Location

United States

Related Subject Headings

  • Young Adult
  • Radius
  • Orthopedics
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Joint Capsule
  • Humans
  • Female
  • Epiphyses