Tesis

Rerata Parameter Antropometri Tulang Kepala Radius pada Populasi Indonesia dengan Tinggi Badan Di Bawah Rata-Rata dan Kesesuaiannya dengan Prostesis Kepala Radius yang Tersedia Secara Komersial di Indonesia = Average Anthropometric Parameters of Radial Head Bone in the Indonesian Population with Below-Average Height and Its Compatibility with Commercially Available Radial Head Prostheses in Indonesia.

Latar Belakang: Penggantian kepala radius dengan prostesis logam diterima secara luas sebagai pengobatan standar untuk fraktur kepala radius yang tidak dapat diperbaiki. 2 Sebagian besar prostesis dirancang di negara-negara Barat berdasarkan karakteristik anatomi populasi Barat.4 Terdapat kemungkinan bahwa masyarakat Indonesia yang memiliki tinggi badan dibawah rata-rata rentan mengalami ketidaksesuaian terhadap prostesis yang tersedia. Tujuan dari penelitian ini adalah untuk mengevaluasi rerata parameter antropometri radius proksimal pada populasi tersebut dan menganalisa kesesuaiannya dengan prostesis yang tersedia secara komersial di Indonesia. Metode: Siku dominan dari 118 partisipan (pria dan wanita) Indonesia dengan rentang usia 20 – 60 tahun dengan tinggi badan di bawah rata-rata (pria ≤ 166 cm, wanita ≤ 154 cm) diteliti. Menggunakan gambaran radiografi anteroposterior dan lateral standar, diukur diameter dan ketebalan kepala radius, jarak antara permukaan artikular dan tuberositas radius, diameter leher intramedular radius, serta diameter luar leher radius. Korelasi antara tinggi badan dan setiap parameter radiografi dianalisa dengan uji statistik dan dinilai koefisien korelasinya. Spesifikasi prostesis kepala radius komersial yang ada di Indonesia ditinjau dan digunakan untuk mengevaluasi parameter radiografi yang relevan dan dinilai kesesuaiannnya. Hasil: Rata-rata diameter kepala minimal dan maksimal adalah 20,49 ± 1,90 mm dan 21,20 ± 1,99 mm; ketebalan rata-rata 10,88 ± 1,37 mm; jarak antara permukaan artikular dan tuberositas 22,15 ± 2,39 mm; diameter intramedular leher radius 7,01 ± 1,50 mm; dan diameter luar leher radius 11,35 ± 1,40 mm. Terdapat korelasi sedang antara tinggi badan dan parameter pada ketebalan kepala radius, diameter intramedular dan diameter luar leher radius (Spearman Koefisien Korelasi 0,40–0,599) dan tinggi pada diameter kepala radius minimal, diameter kepala radius maksimal dan jarak artikular-tuberositas (Spearman Koefisien Korelasi 0,60–0,799). Ditemukan semua rerata parameter pada wanita lebih kecil dibandingkan dengan pria dan secara statistik terdapat perbedaan yang signifikan (p < 0,05). Terdapat 32,5% peserta yang memiliki diameter kepala radius (baik minimal dan maksimal) dibawah 20 mm, dengan diameter kepala radius minimal terkecil 16,8 mm dan diameter kepala radius maksimal terkecil 17,2 mm. Ketebalan kepala minimal prostesis terlihat sama atau lebih kecil dari nilai rata-rata ketebalan kepala radius pada peserta. Terdapat 7,5% peserta yang memiliki jarak antara artikular dan tuberositas lebih kecil dari prostesis. Didapatkan 7,5% peserta memiliki diameter intramedular leher radius yang lebih kecil dari ukuran batang terkecil prostesis komersial, dengan diameter intramedular leher radius terkecil tercatat 3,2 mm. Kesimpulan: Tinggi badan memiliki pengaruh terhadap setiap parameter antropometri tulang kepala radius, terutama pada sumbu longitudinal tulang. Terdapat perbedaan dalam antropometri tulang kepala radius antara wanita dan pria pada populasi Indonesia dimana wanita lebih kecil daripada pria. Penggunaan prostesis kepala radius didapatkan belum sesuai pada populasi Indonesia dengan tinggi badan di bawah rata-rata, terutama pada prostesis yang diproduksi dari Barat (impor).
Kata Kunci: Antropometri; Kepala Radius; Radius Proksimal; Populasi Indonesia; Tinggi Badan di Bawah Rata-Rata; Prostesis Kepala Radius; Artroplasti


Background: Radial head replacement with a metal prosthesis is widely recognized as the standard treatment for irreparable radial head fractures. 2 However, most prostheses are designed in Western countries, based on the anatomical characteristics of Western populations. 4 It is possible that the Indonesian population, with an average height below the global standard, may be more susceptible to prosthesis mismatches. The aim of this study is to evaluate the average anthropometric parameters of the proximal radius in this population and analyze their compatibility with commercially available prostheses in Indonesia. Methods: The dominant elbows of 118 Indonesian participants (both male and female) aged 20–60 years with below-average height (men ≤ 166 cm, women ≤ 154 cm) were examined. Standard anteroposterior and lateral radiographic images were used to measure the diameter and thickness of the radial head, the distance between the articular surface and the radial tuberosity, the intramedullary canal diameter, and the outer diameter of the radial neck. Correlations between height and each radiographic parameter were analyzed using statistical tests, and correlation coefficients were assessed. The specifications of commercially available radial head prostheses in Indonesia were reviewed and compared with the relevant radiographic parameters. Results: The mean minimum and maximum head diameters were 20.49 ± 1.90 mm and 21.20 ± 1.99 mm, respectively; the mean thickness was 10.88 ± 1.37 mm; the distance between the articular surface and the tuberosity was 22.15 ± 2.39 mm; the intramedullary canal diameter was 7.01 ± 1.50 mm; and the outer diameter of the radial neck was 11.35 ± 1.40 mm. There was a moderate correlation between height and parameters such as radial head thickness, intramedullary diameter, and outer neck diameter (Spearman Correlation Coefficient 0.40–0.599), and a strong correlation for minimum and maximum head diameters, as well as the articular-tuberosity distance (Spearman Correlation Coefficient 0.60–0.799). All mean parameters in females were smaller than those in males, with statistically significant differences (p < 0.05). A total of 32.5% of participants had radial head diameters (both minimum and maximum) below 20 mm, with the smallest recorded minimum diameter being 16.8 mm and the smallest maximum diameter being 17.2 mm. The minimum prosthetic head thickness was found to be the same or smaller than the average head thickness in participants. Additionally, 7.5% of participants had an articular-tuberosity distance smaller than that of the prosthesis, and 7.5% had an intramedullary canal diameter smaller than the smallest stem size of the commercial prostheses, with the smallest recorded intramedullary diameter being 3.2 mm. Conclusions: Height influences every anthropometric parameter of the radial head, particularly along the longitudinal axis of the bone. There are significant differences in radial head anthropometry between men and women in the Indonesian population, with women exhibiting smaller dimensions than men. Radial head prostheses have been found to be inadequately suited for the Indonesian population with below-average height, particularly those prostheses produced in Western countries (imports).
Keywords: Anthropometry; Radial Head; Proximal Radius; Indonesian Population; Below-Average Height; Radial Head Prosthesis; Arthroplasty