Micro-CT Density Analysis of the Medial Wall of the Human Medial Cuneiform.

Abstract:

:The human medial cuneiform is incompletely characterized with regard to anatomical morphology, including mineral density and bone quality. Clinically, we have observed failures of fixation by pull-through of devices through relatively soft medial bone. Defining patterns of relative density may provide valuable information regarding implant placement as higher cortical density bone may offer better resistance to such failures. We sought to identify an area of greatest density along the medial wall of the medial cuneiform.Ten fresh-frozen human cadaveric medial cuneiforms underwent micro-computed tomography imaging. Images were analyzed to obtain densities in 4 quadrants along the medial wall of the medial cuneiform. Seven of 10 specimens revealed a maximum density in the plantar distal quadrant of the medial wall of the medial cuneiform. Chi-square goodness-of-fit testing indicated that the density of this quadrant was significantly different from 3 other quadrants (P<.009). Using the Principle of Standard Residuals, the density of the plantar distal quadrant was significantly different than the other 3.We conclude that the plantar distal quadrant of the medial cuneiform contains bone of maximal density when compared to 3 other quadrants. Surgeons who place implants in this region should be aware that this area might offer better resistance to fixation failure.

journal_name

Orthopedics

journal_title

Orthopedics

authors

Pelt CE,Turner CM,Bachus KN,Foreman KB,Beals TC

doi

10.3928/01477447-20110317-07

subject

Has Abstract

pub_date

2011-05-18 00:00:00

pages

363

issue

5

eissn

0147-7447

issn

1938-2367

journal_volume

34

pub_type

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