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Bony anatomy of the third metacarpal and relationship with the capitate: a computed tomography study

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Abstract

Purpose

The purpose of this study was to accurately establish the anatomical variability of the third metacarpal, its medullary canal, and the relationship with the capitate in the context of high rates of component loosening still seen in total wrist arthroplasty.

Methods

CT scans of a 100 hands (age: 41 ± 14 years (range: 16–71 years); male/female ratio: 53/47) were studied to establish the detailed anatomy of the third metacarpal and the capitate.

Results

Although the shape of the third metacarpal and the angles formed with the capitate were highly variable, the third metacarpal length was longer in males (p < 0.001), the proximal cortical bone was thicker (p < 0.001) and the sagittal metacarpal-capitate axis offset was greater (p = 0.01). A relationship was found between the total length of the metacarpal and the distance to the isthmus from the base (r = 0.63; p < 0.0001) which was unaffected by gender. No age-related relationships were significant.

Conclusion

The anatomy of the third metacarpal and capitate varies considerably more than has been alluded to in current wrist arthroplasty literature. Differences between males and females can likely be attributed to hand size. The distance of the isthmus from the base can be predicted from the total length of the metacarpal with a standard error of 1.9 mm.

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Authors and Affiliations

  1. Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Clinical Building, 4th Floor, Tygerberg Campus, Tygerberg, Cape Town, 7505, South Africa

    Rudolph G. Venter, Marilize C. Burger, Ajmal Ikram & Robert P. Lamberts

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  1. Rudolph G. Venter
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  2. Marilize C. Burger
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  3. Ajmal Ikram
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  4. Robert P. Lamberts
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Contributions

RG Venter: Protocol and project development, Data collection, Data analysis, Manuscript writing and editing. MC Burger: Data analysis, Manuscript writing and editing. A Ikram: Protocol and project development, Data collection, Manuscript writing and editing. RP Lamberts: Protocol and project development, Data analysis, Manuscript writing and editing.

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Correspondence to Robert P. Lamberts.

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Venter, R.G., Burger, M.C., Ikram, A. et al. Bony anatomy of the third metacarpal and relationship with the capitate: a computed tomography study. Surg Radiol Anat 41, 1319–1324 (2019). https://doi.org/10.1007/s00276-019-02272-1

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  • DOI: https://doi.org/10.1007/s00276-019-02272-1

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