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The Sigmoid Notch View for Distal Radius Fractures.

Publication ,  Journal Article
Kamal, RN; Leversedge, F; Ruch, DS; Mithani, SK; Cotterell, IHF; Richard, MJ
Published in: J Hand Surg Am
November 2018

PURPOSE: This study defines the sigmoid notch view of the distal radius. Specifically, we tested the null hypothesis that there is no relationship between the subchondral stripe of bone seen on a sigmoid notch view of the distal radius and the articular surface of the sigmoid notch. METHODS: We used 44 wrist specimens for anatomic and fluoroscopic analysis. We measured the articular depth of the sigmoid notch from its deepest point and classified the shape of the sigmoid notch. We then placed a radiopaque marker at the nadir of the articular surface and quantified the fluoroscopic depth of the sigmoid notch. A sigmoid notch view, which was a tangential fluoroscopic view of the volar and dorsal lips of the sigmoid notch, was obtained. The relationship of the articular surface to the stripe of subchondral bone seen on this view, called the sigmoid stripe, was determined. RESULTS: Anatomic analysis revealed sigmoid notch types with proportions similar to those in previous descriptions. The marker for the articular surface was superimposed or just ulnar to the sigmoid stripe in all specimens. In flat face and ski slope notches, this was coincident with the volar and dorsal lips of the sigmoid notch. In C- and S-type notches, there was a measurable distance from the articular surface marker to the edges of the bone of the volar and dorsal lips of the sigmoid. CONCLUSIONS: The articular surface marker at the nadir of the sigmoid notch is always coincident or ulnar to the sigmoid stripe in the sigmoid notch view. CLINICAL RELEVANCE: Surgeons can use the sigmoid notch view as a reliable method to (1) evaluate the integrity of the articular surface, (2) ensure hardware is not placed in the distal radioulnar joint, and (3) guide placement of volar locking plates in the coronal plane.

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Published In

J Hand Surg Am

DOI

EISSN

1531-6564

Publication Date

November 2018

Volume

43

Issue

11

Start / End Page

1038.e1 / 1038.e5

Location

United States

Related Subject Headings

  • Ulna
  • Radius Fractures
  • Radius
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Fluoroscopy
  • Female
  • Aged, 80 and over
 

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Kamal, R. N., Leversedge, F., Ruch, D. S., Mithani, S. K., Cotterell, I. H. F., & Richard, M. J. (2018). The Sigmoid Notch View for Distal Radius Fractures. J Hand Surg Am, 43(11), 1038.e1-1038.e5. https://doi.org/10.1016/j.jhsa.2018.03.016
Kamal, Robin N., Fraser Leversedge, David S. Ruch, Suhail K. Mithani, Ilvy H. F. Cotterell, and Marc J. Richard. “The Sigmoid Notch View for Distal Radius Fractures.J Hand Surg Am 43, no. 11 (November 2018): 1038.e1-1038.e5. https://doi.org/10.1016/j.jhsa.2018.03.016.
Kamal RN, Leversedge F, Ruch DS, Mithani SK, Cotterell IHF, Richard MJ. The Sigmoid Notch View for Distal Radius Fractures. J Hand Surg Am. 2018 Nov;43(11):1038.e1-1038.e5.
Kamal, Robin N., et al. “The Sigmoid Notch View for Distal Radius Fractures.J Hand Surg Am, vol. 43, no. 11, Nov. 2018, pp. 1038.e1-1038.e5. Pubmed, doi:10.1016/j.jhsa.2018.03.016.
Kamal RN, Leversedge F, Ruch DS, Mithani SK, Cotterell IHF, Richard MJ. The Sigmoid Notch View for Distal Radius Fractures. J Hand Surg Am. 2018 Nov;43(11):1038.e1-1038.e5.
Journal cover image

Published In

J Hand Surg Am

DOI

EISSN

1531-6564

Publication Date

November 2018

Volume

43

Issue

11

Start / End Page

1038.e1 / 1038.e5

Location

United States

Related Subject Headings

  • Ulna
  • Radius Fractures
  • Radius
  • Orthopedics
  • Middle Aged
  • Male
  • Humans
  • Fluoroscopy
  • Female
  • Aged, 80 and over