Abstract：
Appropriate management of radial head fractures is integral to prevent long-term consequences like chronic pain and loss of motion. Advanced imaging systems, like micro-computed tomography (μCT), are valuable for understanding radial head fracture patterns as they utilize micrometer scale resolution to define important parameters of bone health like cortical density and trabecular thickness. The purpose of this study was to identify and describe the structural morphology of the radial head utilizing μCT. Nine fresh-frozen cadaveric human radii were divided into four equal quadrants, based, and labeled as posteromedial, posterolateral, anteromedial, and anterolateral. Quadrants were scanned with a SCANCO MicroCT40 with both cortical and cancellous bone density measurements at a resolution of 36.0 μm. Bone density, direct trabecular number, and trabecular thickness were recorded as milligrams of hydroxyapatite/cm3. A one-way repeated measures ANOVA was performed to compare the bone densities, trabecular number, and trabecular thickness of each of the four quadrants (p < 0.05). The posteromedial quadrant contained substantially more bone than other quadrants. Significantly greater bone densities were found in the posteromedial quadrant (148.1 mg of HA/cm3) compared to the anteromedial quadrant (54.6 mg of HA/cm3), posterolateral quadrant (137.5 mg of HA/cm3) compared to the anteromedial quadrant (54.6 mg of HA/cm3), and posterolateral quadrant (137.5 mg of HA/cm3) compared to the anterolateral quadrant (58.1 mg of HA/cm3). The trabecular number was not significantly different between quadrants. Trabecular thickness was significantly lower in the anterolateral (0.1417 mg of HA/cm3) and anteromedial (0.1416 mg of HA/cm3) quadrants compared to the posteromedial (0.1809 mg of HA/cm3) quadrant. The posterior half of the radial head was found to have a higher density of columns and arches compared to the anterior half. The microstructure of trabecular bone in the distal radius forms columns, struts, and arches, which allow for efficient transmission of stress through the bone. The microstructure of the radial head has similar microarchitecture to the distal radius with the present study identifying the presence of columns and arches in the radial head. These structures, along with trabecular density, in the posterior radial head may explain the lower incidence of fractures involving the posterior half of the radial head. Furthermore, our study supports the idea that the high incidence of fractures involving the anterolateral quadrant is due to microarchitecture characteristics and the relative lack of supportive structures compared to other areas. The novel insight gained from this study will aid in the development of advanced interventions for preventative measures and better treatment of radial head fractures like more satisfactory purchase when screws are directed towards the denser posteromedial quadrant.
摘要：
桡骨头骨折的适当管理是不可或缺的，以防止长期后果，如慢性疼痛和运动丧失。先进的成像系统，像显微计算机断层扫描(μCT)，对于理解桡骨头骨折模式很有价值，因为它们利用微米级分辨率来定义骨骼健康的重要参数，如皮质密度和小梁厚度。这项研究的目的是利用μCT识别和描述放射状头的结构形态。将九个新鲜冷冻的尸体人体半径分为四个相等的象限，基于,并标记为后内侧，后外侧,前内侧,和前外侧。用SCANCOMicroCT40扫描象限，以36.0μm的分辨率进行皮质和松质骨密度测量。骨密度,直接骨小梁数，和小梁厚度记录为毫克羟基磷灰石/cm3。进行单向重复测量ANOVA以比较骨密度，小梁数,和四个象限中每个象限的小梁厚度(p<0.05)。后内侧象限比其他象限包含更多的骨骼。与前内侧象限（54.6mgHA/cm3）相比，后内侧象限（148.1mgHA/cm3）的骨密度明显更高，后外侧象限（137.5mgHA/cm3）与前内侧象限（54.6mgHA/cm3）相比，和后外侧象限（137.5mgHA/cm3）与前外侧象限（58.1mgHA/cm3）相比。象限之间的小梁数量没有显着差异。与后内侧（0.1809mgHA/cm3）象限相比，前外侧（0.1417mgHA/cm3）和前内侧（0.1416mgHA/cm3）象限的小梁厚度显着降低。与前半部相比，发现radial头的后半部具有更高的圆柱和拱形密度。桡骨远端骨小梁的微结构形成柱状,struts,和拱门，这允许通过骨骼有效地传递应力。桡骨头的微观结构与桡骨远端具有相似的微观结构，本研究确定了桡骨头中存在柱和拱。这些结构，随着小梁密度，在桡骨头后部可以解释较低的发生率涉及桡骨头后半部的骨折。此外，我们的研究支持以下观点:与其他区域相比,前外侧象限的骨折发生率较高是由于微结构特征和相对缺乏支持结构.从这项研究中获得的新颖见解将有助于开发针对预防措施的先进干预措施，并更好地治疗桡骨头骨折，例如当螺钉指向较密集的后内侧象限时，购买更令人满意的购买。
