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2023, Vol. 27 ›› Issue (27): 4357-4361Effect of sigmoid notch of distal radius on the stability of distal radioulnar joint based on CT imagesShang Zijian1, Guo Lin2, Wang Zhi2, Meng Xianghong2, Chen Fei2, Zhang Xuejun1
Abstract: BACKGROUND: Studies have shown that the bony anatomy of the radius and ulna plays a role in the stability of the distal radioulnar joint, especially the shape of the distal radius sigmoid notch. Previous studies have mostly focused on cadaver studies or biomechanical studies, while few studies have used imaging methods to assess the effect of morphology on the stability of the distal radioulnar joint. METHODS: The CT images of wrist and forearm of 151 cases were analyzed retrospectively. According to the morphological characteristics of the sigmoid notch of the distal radius on the axial CT image, it was divided into four shapes “Flat”, “Ski”, “C” and “S”. The chi-square test was used to compare the differences between the 4-type notch. According to the clinical diagnosis of distal radioulnar joint instability, they were divided into instability group and stability group to compare the effects of different forms of radial sigmoid notch on the stability of distal radioulnar joint. RESULTS AND CONCLUSION: (1) There were 151 patients with wrist injury, including 77 males and 74 females, with an average age of 39.0 (55.0-32.0) years. There were 42 cases of Flat type radial sigmoid notch (27.8%), 47 cases of Ski type radial sigmoid notch (31.1%), 39 cases of C type radial sigmoid notch (25.8%), and 23 cases of S type radial sigmoid notch (15.2%). (2) According to the clinical diagnosis, the patients were divided into distal radioulnar joint instability group and stability group. There were 85 cases (56.3%) in the instability group, including 27 cases of Flat type, 30 cases of Ski type, 11 cases of C type and 17 cases of S type. There were 66 cases (43.7%) in the stable group, including 15 cases of Flat type, 17 cases of Ski type, 28 cases of C type and 6 cases of S type. (3) The statistical results showed that there were significant differences in the stability of distal radioulnar joint with different shapes of sigmoid notch of distal radius (Pearson X2=17.583, P=0.001). The distal radioulnar joint instability rate of type C sigmoid notch was the lowest, and there was a statistical difference with the other three types. The instability rate of distal radioulnar joint in Flat, S and Ski type sigmoid notch was higher, and there was no significant difference among the three groups. (4) It is concluded that Ski type and Flat type sigmoid notches of the distal radius are the most common, while type C sigmoid notch of the distal radius is helpful to maintain the stability of distal radioulnar joint. Key words: distal radius, distal radioulnar joint, sigmoid notch, CT, stability |