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Morphometrics of the human thumb metacarpal bone: interest for developing an osseointegrated prosthesis

  • Anatomic Bases of Medical, Radiological and Surgical Techniques
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Abstract

Introduction

Amputation of the thumb presents a serious insult to the hand and diminished quality of life for a patient physically, vocationally, and possibly psychologically. The aim of this study was to define the geometry of the thumb metacarpal in order to help create a standardized set of transcutaneous osseointegrated prostheses to treat patients who have suffered amputation of the thumb at the level of the metacarpophalangeal joint.

Materials and methods

A total of 80 metacarpals from 46 cadavers were studied. All soft tissues were removed and the thumb metacarpals were imaged using computed tomography. Three-dimensional models were constructed using images from the coronal, sagittal, and axial planes. Using HyperMesh™ CAD software, the bones were analyzed for overall length, radius of curvature, medullary canal diameter, cortical thickness, and distance to the isthmus, defined as the narrowest portion of the intramedullary canal.

Results

The average length of the first metacarpal was 47.6 mm (±3.3 mm, 39.2–56.9 mm). The average radius of curvature was 55.5 mm (±10.7 mm, 33–78.9 mm). Inner bone diameter, measured in two axes, was 10.5 mm (±1.3 mm, 5.4–18.7 mm) for the major axis and 7.7 mm (±0.9 mm, 4.3–17.8 mm) for the minor axis. The average cortical thickness was 1.4 mm (±0.3 mm, 0.7–3.1 mm). The distance to the center of the isthmus from the distal end had an average length of 21.3 mm (±1.9 mm, 17–25 mm).

Conclusions

Using these findings a standardized set of intramedullary stems can be developed as a base for a transcutaneous osseointegrated prosthesis, helping to create a reliable method for treating patients with amputated thumbs.

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References

  1. Albrektsson T, Branemark PI, Jacobsson M et al (1987) Present clinical applications of osseointegrated percutaneous implants. Plast Reconstr Surg 79(5):721–731

    Article  CAS  PubMed  Google Scholar 

  2. American Medical Association (2008) Guides to the evaluation of permanent impairment. Sixth edn, pp 20–5

  3. Ashbaugh H, Gellman H (2009) Congenital thumb deformities and associated syndromes. J Craniofac Surg 20(4):1039–1044

    Article  PubMed  Google Scholar 

  4. Branemark R, Berlin O, Hagberg K et al (2014) A novel osseointegrated percutaneous prosthetic system for the treatment of patients with transfemoral amputation: a prospective study of 51 patients. Bone Joint J Br 96(1):106–113

    Article  Google Scholar 

  5. Dillingham TR, Pezzin LE, MacKenzie EJ (2002) Limp amputation and limb deficiency: epidemiology and recent trends in the United States. South Med J 95(8):875–883

    PubMed  Google Scholar 

  6. Doppen P, Solomons M, Kritzinger S (2009) Osseointegrated finger prostheses. J Hand Surg 34(1):29–34

    Article  CAS  Google Scholar 

  7. Friedrich JB, Vedder NB (2011) Thumb reconstruction. Clin Plast Surg 38(4):697–712

    Article  PubMed  Google Scholar 

  8. Hacking SA, Bobyn JD, Toh KK, Tanzer M, Krygier JJ (2000) Fibrous tissue ingrowth and attachment to porous tantulum. J Biomed Mater Res 52(4):631–638

    Article  CAS  PubMed  Google Scholar 

  9. Henry SL, Wei FC (2010) Thumb reconstruction with toe transfer. J Hand Microsurg 2(2):72–78

    Article  PubMed Central  PubMed  Google Scholar 

  10. Jeyapalina S, Beck JP, Bachus KN et al (2012) Efficacy of a porous-structured titanium subdermal barrier for preventing infection in percutaneous osseointegrated prostheses. J Orthop Res 30(8):1304–1311

    Article  CAS  PubMed  Google Scholar 

  11. Lin PY, Sebastin SJ, Ono S, Bellfi LT, Chang KW, Chung KC (2011) A systematic review of outcomes of toe-to-thumb transfers for isolated traumatic thumb amputation. Hand 6(3):235–243

    Article  PubMed Central  PubMed  Google Scholar 

  12. Lundborg G, Branemark PI, Rosen B, Malmo Goteborg (1996) Osseointegrated thumb prostheses: a concept for fixation of digit prosthetic devices. J Hand Surg 21(2):216–221

    Article  CAS  Google Scholar 

  13. Sabapathy SR, Venkatramani H, Bhardwaj P (2013) Reconstruction of the thumb amputation at the carpometacarpal joint level by groin flap and second toe transfer. Injury 44(1):370–375

    Article  PubMed  Google Scholar 

  14. Smith SL (2000) Shape variation of the human pollical distal phalanx and metacarpal. Am J Phys Anthropol 113(3):329–348

    Article  CAS  PubMed  Google Scholar 

  15. Tsikandylakis G, Berlin O, Branemark R (2014) Implant survival, adverse events, and bone remodeling of osseointegrated percutaneous implants for transhumeral amputee. Clin Orthop Relat Res 472(10):2947–2956

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank the Colorado State Anatomical Board for allowing us to use the cadaver metacarpals for our research. We would also like to thank Jeffrey E Bischoff PhD at Zimmer, Inc., for creating the solid models; Elizabeth Moran at Parker Adventist Hospital for her help in collecting the CT data; and Dr Peter J Laz PhD at Denver University for his help with the use of the HyperMesh software.

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Authors and Affiliations

  1. Department of Structural Medicine, Rocky Vista University College of Osteopathic Medicine, Parker, CO, USA

    J. J. Vaux & C. K. Funk

  2. Colorado Limb Consultants, Denver, CO, USA

    R. R. Hugate

  3. Mechanical Engineering, Denver University, Denver, CO, USA

    J. W. Hills

  4. Diversified Radiology, Lakewood, CO, USA

    R. F. Grzybowski

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  1. J. J. Vaux
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  2. R. R. Hugate
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  3. J. W. Hills
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  4. R. F. Grzybowski
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  5. C. K. Funk
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Correspondence to J. J. Vaux.

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Vaux, J.J., Hugate, R.R., Hills, J.W. et al. Morphometrics of the human thumb metacarpal bone: interest for developing an osseointegrated prosthesis. Surg Radiol Anat 38, 127–133 (2016). https://doi.org/10.1007/s00276-015-1524-6

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  • DOI: https://doi.org/10.1007/s00276-015-1524-6

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