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Three-dimensional cortical and trabecular bone microstructure of the proximal ulna

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The three-dimensional (3D) microstructure of the cortical and trabecular bone of the proximal ulna has not yet been described by means of high-resolution 3D imaging. An improved characterization can provide a better understanding of their relative contribution to resist impact load. The aim of this study is to describe the proximal ulna bone microstructure using micro-computed tomography (micro-CT) and relate it to gross morphology and function.

Materials and methods

Five dry cadaveric human ulnae were scanned by micro-CT (17 μm/voxel, isotropic). Both qualitative and quantitative assessments were performed on sagittal image stacks. The cortical thickness of the trochlear notch and the trabecular bone microstructure were measured in the olecranon, bare area and coronoid.

Results

Groups of trabecular struts starting in the bare area, spanning towards the anterior and posterior side of the proximal ulna, were observed; within the coronoid, the trabeculae were orthogonal to the joint surface. Consistently among the ulnae, the coronoid showed the highest cortical thickness (1.66 ± 0.59 mm, p = 0.04) and the olecranon the lowest (0.33 ± 0.06 mm, p = 0.04). The bare area exhibited the highest bone volume fraction (BV/TV = 43.7 ± 22.4%), trabecular thickness (Tb.Th = 0.40 ± 0.09 mm) and lowest structure model index (SMI = – 0.28 ± 2.20, indicating plate-like structure), compared to the other regions (p = 0.04).

Conclusions

Our microstructural results suggest that the bare area is the region where most of the loading of the proximal ulna is concentrated, whereas the coronoid, together with its anteromedial facet, is the most important bony stabilizer of the elbow joint. Studying the proximal ulna bone microstructure helps understanding its possible everyday mechanical loading conditions and potential fractures.

Level of evidence

N.A.

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Acknowledgements

We thank the Ray Last Anatomy Laboratory at The University of Adelaide for the provision of cadaveric bone specimens, Adelaide Microscopy for providing access to the micro-CT system, Dr. Marco Palanca for the help and valuable suggestions, The International Society of Arthroscopy, Knee Surgery and Orthopedic Sports Medicine (ISAKOS) for covering the costs of micro-CT imaging.

Funding

This study was funded by the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) to cover the costs of micro-CT imaging.

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Authors and Affiliations

  1. Department of Orthopedic and Trauma Surgery, College of Medicine and Public Health Flinders University and Flinders Medical Centre, Adelaide, SA, 5042, Australia

    Jetske Viveen, Shima Zahrooni, Ruurd L. Jaarsma, Job N. Doornberg & Gregory I. Bain

  2. Department of Orthopedic Surgery, University of Amsterdam, 1105 AZ, Amsterdam-Zuidoost, The Netherlands

    Jetske Viveen & Job N. Doornberg

  3. Medical Device Research Institute, College of Science and Engineering, Flinders University, GPO Box 2100, Adelaide, SA, 5001, Australia

    Egon Perilli

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  1. Jetske Viveen
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Correspondence to Jetske Viveen.

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Conflict of interest

Author #1 received an unrestricted Research Grant from the Marti-Keuning-Eckhardt Foundation, Jo Kolk Foundation and Michael-van Vloten Foundation. Author #5 received an unrestricted Postdoc Research Grant from the Marti-Keuning-Eckhardt Foundation. Other authors declare that they have no conflict of interest.

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Viveen, J., Perilli, E., Zahrooni, S. et al. Three-dimensional cortical and trabecular bone microstructure of the proximal ulna. Arch Orthop Trauma Surg 143, 213–223 (2023). https://doi.org/10.1007/s00402-021-04023-7

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