Öz
Amaç: Ekstremite kemikleri arasındaki morfolojik varyasyonların bilinmesi, bazı hastalıkların patogenezinin veya altta yatan mekanizmanın anlaşılmasında ve tedavisinde yararlıdır. Bu çalışmada sigmoid çentik tipi, lunat tip, sigmoid C tipi derinlik ve ulnar varyansın cinsiyet ve yaşa göre değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Bu çalışmaya Bilgisayarlı tomografi çekilen 18-68 yaş arası 252 birey (88 kadın ve 164 erkek) dahil edilmiştir. Kadınların yaş ortalaması 46.59±14.67 yıl iken, erkeklerin yaş ortalaması 43.11±14.08 yıl olarak hesaplandı. Ayrıca, sigmoid çentik tipleri sınıflandırıldı ve sigmoid çentik derinliği ölçüldü. Lunat tipleri ve ulnar varyans tipleri her iki cinsiyet ve yaş için değerlendirildi.
Bulgular: Sigmoid çentik tipleri cinsiyetler arasında anlamlı farklılık gösterirken, lunat tipleri, Sigmoid C tipi derinliği ve ulnar varyans açısından cinsiyetler arasında anlamlı bir farklılık bulunmadı. Kadınlarda ve erkeklerde C tipi derinlik ortalaması sırasıyla 2.54±0.50 mm ve 2.40±0.41 mm olarak bulundu. Sigmoid çentik tipleri, ulnar varyans varlığı ve tipleri ile lunat tipleri, yaş aralıkları açısından anlamlı farklılık gösterdi.
Sonuç: El bileği ile ilgili değerlendirmelerin, bu bölge ile ilgilenen klinisyenlere anatomik ve morfolojik açıdan referans değerler sağlamasından dolayı bu bölgede oluşabilecek problemlerin ve tedavilerin planlanması konusunda yol göstereceğine inanıyoruz. Ayrıca, bu veriler rekonstrüktif prosedürler düşünülürken veya distal radioulnar eklemi içeren karmaşık kırıklara müdahale gerektiğinde bir rehber olabilir.
Anahtar Kelimeler
Incisura sigmoideus sigmoid derinlik lunat tipleri distal radioulnar eklem
Etik Beyan
2025;151:8 nay tarihi
Destekleyen Kurum
Yok
Teşekkür
Yok
Kaynakça
- Bhat AK, Fijad NR, Acharya AM. Morphometry of sigmoid notch: A novel method of shape assessment for clinical practice. J Orthop. 2023;47:80-6.
- De Smet L, Fabry G. Orientation of the sigmoid notch of the distal radius: determination of different types of the distal radioulnar joint. Acta Orthop Belg. 1993;59:269-72.
- Mauler F, Boudabbous S, Beaulieu JY. Midsectional magnetic resonance imaging analysis of the sigmoid notch of the distal radioulnar joint. J Wrist Surg. 2022;12:170-6.
- D'Sa H, Willing R, Murray T, Rowan K, Grewal R, King G et al. Reliability of the sigmoid notch classification of the distal radioulnar joint. J Wrist Surg. 2022;12:359-63.
- 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;43:1038.e1-1038.e5.
- Kamaci S, Oral M, Yilmaz ET, Aksoy T, Kafa B, Tokgözoğlu M. Displaced sigmoid notch fracture and higher patient age are associated with distal radioulnar joint subluxation. Turk J Med Sci. 2024;54:368-75.
- Kim BS, Jung KJ, Nho JH, Kim HK, Kim G. Morphologic Characteristics of the sigmoid notch of the distal radius for patients with peripheral triangular fibrocartilage complex tear. Orthopedics. 2021;44:e729-34.
- Roner S, Fürnstahl P, Scheibler AG, Sutter R, Nagy L, Carrillo F. Three-Dimensional automated assessment of the distal radioulnar joint morphology according to sigmoid notch surface orientation. J Hand Surg Am. 2020;45:1083-e1
- Viegas SF, Wagner K, Patterson R, Peterson P. Medial (hamate) facet of the lunate. J Hand Surg Am. 1990;15:564-71.
- Fowler JR, Hughes TB. Scaphoid fractures. Clin Sports Med. 2015;34:37-50.
- Sayit E, Tanrivermis Sayit A, Bagir M, Terzi Y. Ulnar variance according to gender and side during aging: An analysis of 600 wrists. Orthop Traumatol Surg Res. 2018;104:865-9.
- Tolat AR, Sanderson PL, De Smet L, Stanley JK. The gymnast's wrist: acquired positive ulnar variance following chronic epiphyseal injury. J Hand Surg Br. 1992;17:678-81.
- Shivdas S, Hashim MS, Ahmad TS. A three-dimensional virtual morphometry study of the sigmoid notch of the distal radius. J Orthop Surg. 2018;26:1-8.
- Rhee PC, Moran SL. The effect of lunate morphology in carpal disorders: review of the literature. Curr Rheumatol Rev. 2020;16:184-8.
- Galley I, Bain GI, McLean JM. Influence of lunate type on scaphoid kinematics. J Hand Surg Am. 2007;32:842-7.
- Rhee PC, Jones DB, Moran SL, Shin AY. The effect of lunate morphology in Kienböck disease. J Hand Surg Am. 2015;40:738-44.
- Viegas SF. The lunatohamate articulation of the midcarpal joint. Arthroscopy. 1990;6:5-10.
- Nuttall D, Trail IA, Stanley JK. Movement of the scaphoid in the normal wrist. J Hand Surg. 1998;23:762–4.
- Nooh S, Koura A, Kayed M. Ulnar variance detection from radiographic images using deep learning. J Big Data. 2025;12:1-14.
- Daneshvar P, Willing R, Pahuta M, Grewal R, King GJ. Osseous anatomy of the distal radioulnar joint: an assessment using 3-dimensional modeling and clinical implications. J Hand Surg Am. 2016;41:1071-9.
- Claessens AL, Lefevre J, Beunen G, De Smet L, Veer AM. Physique as a risk factor for ulnar variance in elite female gymnasts. Med Sci Sports Exerc. 1996;28:560-9.
- Nakamura R, Tanaka Y, Imaeda T, Miura T. The influence of age and sex on ulnar variance. J Hand Surg Br. 1991;16:84-8.
Öz
Purpose: Knowing the morphological variations among the extremity bones is useful in understanding the pathogenesis, or underlying mechanism, and treatment of some disorders. This study aimed to evaluate sigmoid notch type, lunate type, sigmoid C-type depth, and ulnar variance concerning gender and age.
Materials and Methods: This study included 252 subjects (88 females and 164 males) aged 18-68 years who underwent computed tomography. The mean age of the females was 46.59±14.67 years, while the mean age of the males was calculated as 43.11±14.08 years. Moreover, the sigmoid notch types were generated, and the sigmoid notch depth was measured. Lunate types and ulnar variance types were evaluated for both gender and age.
Results: Sigmoid notch types showed a significant difference between genders, whereas no significant difference was found regarding lunate types, sigmoid C-type depth, and ulnar variance. The mean sigmoid C-type depth was 2.54±0.50 mm in females and 2.40±0.41 mm in males, respectively. Sigmoid notch types, ulnar variance presence and types, and lunate types significantly differed in age ranges.
Conclusion: Comprehensive evaluation of the wrist region provides essential anatomical and morphological reference values that can inform clinical decision-making, particularly in the diagnosis and management of pathologies involving the distal radioulnar joint. Additionally, these values are critical for preoperative planning in reconstructive procedures and for addressing complex distal forearm fractures.
Anahtar Kelimeler
Sigmoid notch sigmoid depth lunate types distal radioulnar joint
Etik Beyan
2025;151:8 approval date
Destekleyen Kurum
No
Teşekkür
No
Kaynakça
- Bhat AK, Fijad NR, Acharya AM. Morphometry of sigmoid notch: A novel method of shape assessment for clinical practice. J Orthop. 2023;47:80-6.
- De Smet L, Fabry G. Orientation of the sigmoid notch of the distal radius: determination of different types of the distal radioulnar joint. Acta Orthop Belg. 1993;59:269-72.
- Mauler F, Boudabbous S, Beaulieu JY. Midsectional magnetic resonance imaging analysis of the sigmoid notch of the distal radioulnar joint. J Wrist Surg. 2022;12:170-6.
- D'Sa H, Willing R, Murray T, Rowan K, Grewal R, King G et al. Reliability of the sigmoid notch classification of the distal radioulnar joint. J Wrist Surg. 2022;12:359-63.
- 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;43:1038.e1-1038.e5.
- Kamaci S, Oral M, Yilmaz ET, Aksoy T, Kafa B, Tokgözoğlu M. Displaced sigmoid notch fracture and higher patient age are associated with distal radioulnar joint subluxation. Turk J Med Sci. 2024;54:368-75.
- Kim BS, Jung KJ, Nho JH, Kim HK, Kim G. Morphologic Characteristics of the sigmoid notch of the distal radius for patients with peripheral triangular fibrocartilage complex tear. Orthopedics. 2021;44:e729-34.
- Roner S, Fürnstahl P, Scheibler AG, Sutter R, Nagy L, Carrillo F. Three-Dimensional automated assessment of the distal radioulnar joint morphology according to sigmoid notch surface orientation. J Hand Surg Am. 2020;45:1083-e1
- Viegas SF, Wagner K, Patterson R, Peterson P. Medial (hamate) facet of the lunate. J Hand Surg Am. 1990;15:564-71.
- Fowler JR, Hughes TB. Scaphoid fractures. Clin Sports Med. 2015;34:37-50.
- Sayit E, Tanrivermis Sayit A, Bagir M, Terzi Y. Ulnar variance according to gender and side during aging: An analysis of 600 wrists. Orthop Traumatol Surg Res. 2018;104:865-9.
- Tolat AR, Sanderson PL, De Smet L, Stanley JK. The gymnast's wrist: acquired positive ulnar variance following chronic epiphyseal injury. J Hand Surg Br. 1992;17:678-81.
- Shivdas S, Hashim MS, Ahmad TS. A three-dimensional virtual morphometry study of the sigmoid notch of the distal radius. J Orthop Surg. 2018;26:1-8.
- Rhee PC, Moran SL. The effect of lunate morphology in carpal disorders: review of the literature. Curr Rheumatol Rev. 2020;16:184-8.
- Galley I, Bain GI, McLean JM. Influence of lunate type on scaphoid kinematics. J Hand Surg Am. 2007;32:842-7.
- Rhee PC, Jones DB, Moran SL, Shin AY. The effect of lunate morphology in Kienböck disease. J Hand Surg Am. 2015;40:738-44.
- Viegas SF. The lunatohamate articulation of the midcarpal joint. Arthroscopy. 1990;6:5-10.
- Nuttall D, Trail IA, Stanley JK. Movement of the scaphoid in the normal wrist. J Hand Surg. 1998;23:762–4.
- Nooh S, Koura A, Kayed M. Ulnar variance detection from radiographic images using deep learning. J Big Data. 2025;12:1-14.
- Daneshvar P, Willing R, Pahuta M, Grewal R, King GJ. Osseous anatomy of the distal radioulnar joint: an assessment using 3-dimensional modeling and clinical implications. J Hand Surg Am. 2016;41:1071-9.
- Claessens AL, Lefevre J, Beunen G, De Smet L, Veer AM. Physique as a risk factor for ulnar variance in elite female gymnasts. Med Sci Sports Exerc. 1996;28:560-9.
- Nakamura R, Tanaka Y, Imaeda T, Miura T. The influence of age and sex on ulnar variance. J Hand Surg Br. 1991;16:84-8.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | İş ve Meslek Hastalıkları, Ortopedi |
| Bölüm | Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2025 |
| Gönderilme Tarihi | 18 Mart 2025 |
| Kabul Tarihi | 15 Mayıs 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 50 Sayı: 2 |
