- Safe zone for implant insertion: (from Andrew Caputo MD)
- note that the posterolateral portion of the radial head does not articulate with the ulna, and this is termed the safe zone (since hardware
placed here will not enter the articulation);
- zone is approximately 90 deg and lies between a longitudinal line along the radial styloid and a
longitudinal line along Lister's tubercle (with the wrist in neutral rotation);
- safe zone is anterolateral in neutral position and posterolateral in full supination;
- the cartilage in the non articulating zone tends to be thinner and has a yellowish color;
- as noted by AD Soyer 1998, application of a 2.0 or 2.7 mm to the lateral aspect of the radial head and neck with
the forearm in neutral rotation will not result in hardware impingement;
- placement of the plate in the lateral position with the forearm in full pronation will result in loss of the last 30 deg of full supination;
- placement of the plate in the lateral position with the forearm in full supination, can result in loss of the last 10 deg of pronation;
Radial head and neck fractures: anatomic guidelines for proper placement of internal fixation. GR Smith and RN Hotchkiss.
J. Shoulder and Elbow Surg. Vol 5. 1996. p 113-117.
Optimal position for plate fixation of complex fractures of the proximal radius.
A cadaver study. AD Soyer et al.
J. Orthop Trauma.
Vol 12. No 4. p 291-293. 1998.
The non articulating portion of the radial head: anatomic and clinical correlations for internal fixation. AE Caputo Md et al.
J. Hand Surg. Vol 23-A. 1998. p 1092-1090.
