Computer assisted surgery of the distal humerus can employ contralateral images for pre-operative planning, registration, and surgical intervention

BackgroundBone loss at the distal humerus can lead to errors in the identification of the elbow's flexion-extension axis. Referencing the anatomy of the contralateral (uninjured) elbow may prove beneficial in accurately defining this axis. The objective of this study was to compare distal humeral morphology between paired specimens and determine whether geometric differences exist.MethodsMedical CT images of 25 paired, dry cadaveric, distal humeri were acquired and a range of anatomic characteristics were measured, following registration of each pair to a common coordinate system.ResultsThe anthropometric features of the distal humerus were similar from side-to-side, with differences on the order of 1.0° and 0.5 mm.ConclusionsPreoperative imaging of the contralateral normal elbow may be employed in patients with peri-articular bone loss, where referencing anatomic landmarks of the injured side is not possible.Clinical relevanceUsing the contralateral anatomy, a more accurate implant alignment may be achieved when bone loss is sufficiently severe that referencing anatomic landmarks of the injured side is not possible.