CT Density Analysis of the Medial Cuneiform

Panchbhavi, Vinod K.; Boutris, Nickolas; Patel, Karan A.; Molina, Domingo; Andersen, Clark R.

doi:10.1177/1071100713499904

Cited by 13 publications

(7 citation statements)

References 13 publications

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“…35 There are several existing studies that use clinical CT to evaluate BMD in the midfoot. 23 A clinical CT study in the medial cuneiform showed the highest density in the distal-dorsal-lateral site with increasing density in the dorsal and distal directions, 17 matching the density trends seen in our study. Another CT study in the second metatarsal showed higher density in the diaphysis than in the epiphyses, 21 again showing similar results to this study.…”

Section: Discussionsupporting

confidence: 89%

“…Previous research on BMD in the Lisfranc complex is relatively limited. Existing studies have examined single bones or small complexes, such as the medial cuneiform, 17,18 first metatarsal, 19 second metatarsal, 20,21 or first tarso-metatarsal joint, 22 or have looked at larger regions but with a focus in inter-bone differences, 23,24 rather than looking at BMD differences between subregions of the same bone. Additionally, these studies have predominantly used clinical CT and/or DXA imaging, with only one study using micro-CT imaging, 18 and none of the existing literature has been done with a calibration phantom.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Micro‐CT analysis of the Lisfranc complex reveals higher bone mineral density in dorsal compared to plantar regions

Requist

Sripanich

Rolvien

et al. 2021

Journal Orthopaedic Research

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Injuries to the Lisfranc complex may require surgical fixation, the stability of which may be correlated with bone mineral density (BMD). However, there is limited research on regional BMD variations in the Lisfranc complex. This study used quantitative micro-CT to characterize regional BMD in the four bones (medial cuneiform, intermediate cuneiform, first metatarsal, and second metatarsal) of this complex.Twenty-four cadaveric specimens were imaged with a calibration phantom using micro-CT. Each bone was segmented and divided into eight regions based on an anatomical coordinate system. BMD for each octant was calculated using scanspecific calibration equations and average image intensity. Differences between regions were analyzed using ANOVA with post hoc analysis and differences between groups of four octants in each plane were analyzed with t-tests with significance level α = 0.05. The highest density region in the medial cuneiform was the distal-dorsal-lateral and dorsal regions showed significantly higher BMD than plantar regions. The intermediate cuneiform had the highest density in the distal-dorsal-medial region and the dorsal and medial regions had higher BMD than the plantar and lateral regions, respectively. The densest region of the first metatarsal was the distal-dorsal-lateral and distal regions had significantly higher BMD than proximal regions. In the second metatarsal, the distal-dorsal-medial region had the highest density, and the distal, dorsal, and medial regions had significantly higher BMD than the proximal, plantar, and lateral regions, respectively. The predominant finding was a pattern of increased density in the dorsal bone regions, which may be relevant in the surgical management of Lisfranc injuries.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Micro‐CT analysis of the Lisfranc complex reveals higher bone mineral density in dorsal compared to plantar regions

Requist

Sripanich

Rolvien

et al. 2021

Journal Orthopaedic Research

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“…An alternative method of inserting the "home run" screw was proposed by Panchbhavi. 43,44 Instead of the screw entering from a medial to lateral orientation, a cannulated partially threaded 4.0-to 5.0-mm screw can be inserted from the base of M2 into C1. The advantage of this technique is easier targeting, better purchase, and easier removal if broken.…”

Section: Treatmentmentioning

confidence: 99%

Updates on Lisfranc Complex Injuries

Yan

Chen

et al. 2021

Foot & Ankle Orthopaedics

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Lisfranc injuries are a disruption of one or more of the tarsometatarsal joints and have an estimated incidence of 1/55 000 people. However, the total number of Lisfranc injuries could be underreported, because almost 20% of these injuries are initially missed. Because of the relative infrequency of these injuries, the current literature is inconsistent in regard to proper treatment. This article provides a review of Lisfranc complex injuries including relevant anatomy, diagnosis, treatment, classifications, operative approaches, and outcomes and complications. Based on existing evidence, it also proposes an algorithm the authors prefer for the evaluation and treatment of Lisfranc complex injuries.

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“…Bischoff et al 3 used HU to measure BMD at different resection levels for TAA in order to compare bony support for flat versus rounded bone cuts. Panchbhavi et al 28 used CT scans to measure medial cuneiform HU to determine the optimal sites for screw purchase. Patterson et al 29 described measurements of cortical bone thickness of the distal tibia on standard radiographs, which they correlated with DEXA BMD measurements.…”

Section: Discussionmentioning

confidence: 99%

Lower Bone Density on Preoperative Computed Tomography Predicts Periprosthetic Fracture Risk in Total Ankle Arthroplasty

et al. 2018

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Bone mineral density (BMD) is a modifiable factor which can be addressed prior to elective surgery, if necessary. However, its role pertaining to complications of total ankle arthroplasty (TAA) has not been studied. Medial malleolar fractures are a well-known complication of TAA that can occur both intra-and postoperatively, the latter often presenting as stress fractures. 21,45 These fractures may be prevented by insertion of a prophylactic fixation screw prior to proceeding with TAA implantation, although the indications for such fixation are not well defined.

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CT Density Analysis of the Medial Cuneiform

Abstract: The findings of this study may indicate the most optimal area for implant purchase in the medial cuneiform when reducing the diastasis between the base of the second metatarsal and medial cuneiform and for stabilization of the medial column.

Cited by 13 publications

References 13 publications

Micro‐CT analysis of the Lisfranc complex reveals higher bone mineral density in dorsal compared to plantar regions

Micro‐CT analysis of the Lisfranc complex reveals higher bone mineral density in dorsal compared to plantar regions

Updates on Lisfranc Complex Injuries

Lower Bone Density on Preoperative Computed Tomography Predicts Periprosthetic Fracture Risk in Total Ankle Arthroplasty

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