Abstract
Objective
This research investigates the anatomic basis for the repair and reconstruction of hand joints using transposition of the carpometacarpal (CMC) joint of the hamatum.
Methods
The morphology and structure of the CMC joints of the hamatum and the base joints of the middle phalanx were observed on 22 freshly frozen wrist specimens at Shanghai 6th People’s Hospital Research Institute of Microsurgery. The volar dorsal dia, radioulnar dia, depth of concave, and area of the joints were measured. Data were obtained through statistical analysis, and the resemblance of joints was compared in terms of morphology, structure, area, length, and diameter.
Results
The radioulnar dia of the CMC joints of the hamatum (13.54 ± 1.15 mm) did not exhibit any evident differences in the middle phalanx of the forefinger, middle finger, and ring finger, and in the distal phalanx of the thumb. The volar dorsal dia of the CMC joints of the hamatum (10.71 ± 0.93 mm) exhibited an evident difference in the middle phalanx of the ring finger. In all fingers, the depth of the ulnar and radial concave of the CMC joints of the hamatum (1.30 ± 0.08 and 0.95 ± 0.05 mm, respectively) and the area of the CMC joints of the hamatum (139.89 ± 5.44 mm2) showed an evident difference.
Conclusion
The CMC joint of the hamatum could be considered a new and viable joint donor site that could be used to repair and reconstruct the base joints of the middle phalanx.
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References
Jehan S, Chandraprakasam T, Thambiraj S (2012) Management of proximal phalangeal fractures of the hand using finger nail traction and a digital splint: a prospective study of 43 cases. Clin Orthop Surg 4:156–162
Elfar J, Mann T (2013) Fracture-dislocations of the proximal interphalangeal joint. J Am Acad Orthop Surg 21:88–98
Maalla R, Youssef M, Ben Jdidia G, Khimiri C, Essadam H (2012) Extension-block pinning for fracture-dislocation of the proximal interphalangeal joint. Orthop Traumatol Surg Res 98:559–563
Ahern BJ, Showalter BL, Elliott DM, Richardson DW, Getman LM (2013) In vitro biomechanical comparison of a 4.5 mm narrow locking compression plate construct versus a 4.5 mm limited contact dynamic compression plate construct for arthrodesis of the equine proximal interphalangeal joint. Vet Surg 42:335–339
Criner KT, Ilyas AM (2011) Silicone arthroplasty for chronic proximal interphalangeal joint dislocations. Tech Hand Up Extrem Surg 15:209–214
Sweets TM, Stern PJ (2011) Pyrolytic carbon resurfacing arthroplasty for osteoarthritis of the proximal interphalangeal joint of the finger. J Bone Joint Surg Am 93:1417–1425
Yamagami N, Yamamoto S, Tsujimoto Y, Uchio Y (2013) Osteochondral autograft transplantation for malunited intra-articular fracture of the proximal interphalangeal joint: a case report. Arch Orthop Trauma Surg 133:135–139
Korambayil PM, Francis A (2011) Hemi-hamate arthroplasty for pilon fractures of finger. Indian J Plast Surg 44:458–466
Zhang X, Fang X, Shao X, Wen S, Zhu H, Ren C (2012) Osteoarticular pedicle flap from the capitate to reconstruct traumatic defects in the head of the proximal phalanx. J Hand Surg Am 37(9):1780–1790
Cavadas PC, Landin L, Thione A (2010) Reconstruction of the condyles of the proximal phalanx with osteochondral grafts from the ulnar base of the little finger metacarpal. J Hand Surg Am 35(8):1275–1281
Innocenti M, Adani R, Boyer MI (2007) Nonvascularized osteoarticular allograft replacement of the proximal interphalangeal joint after extensive loss of bone, joint, and extensor tendon. Tech Hand Up Extrem Surg 11:149–155
Convert FR, Akeson WH, Keown GH (1972) The repair of large osteochondral defects. A experiment study in horse. Clin Orthop 82:253–262
Williams CS 4th (2012) Proximal interphalangeal joint fracture dislocations: stable and unstable. Hand Clin 28:409–416
Vogt R, Aerni M, Ampofo C, Schmelzer-Schmied N (2012) Proximal interphalangeal (PIP) finger prosthesis—what have we learnt? Experiences over 10 years. Handchir Mikrochir Plast Chir 44:293–299
Murray PM, Linscheid RL, Cooney WP 3rd, Baker V, Heckman MG (2012) Long-term outcomes of proximal interphalangeal joint surface replacement arthroplasty. J Bone Joint Surg Am 94:1120–1128
Goebell R (1913) Ersatz von fingergelenken durch zehengelenke. Muenchen Med Wochenschr 60:1598–1599
Buncke HJ Jr, Daniller AI, Schulz WP, Chase RA (1976) The fate of autogenous whole joints transplanted by microvascular anastomoses. Plast Reconstr Surg 39:333–341
Foucher G, Merle M, Maneaud M, Michon J (1980) Microsurgical free partial toe transfer in hand reconstruction, a report of 12 cases. Plast Reconstr Surg 65:616–627
Pei GX, Ren GH, Ren YJ, Wei KH (2008) Reconstruction of phalangeal articulations of the hand with vascularised phalangeal articulations of foot. Injury 3:S109–S115
O’Brien B, Gould JS, Morrison WA, Russell RC, MacLeod AM, Pribaz JJ (1984) Free vascularized small joint transfer to the hand. J Hand Surg Am 9:634–641
Lichtman DM, Schneider JR, Swafford AR, Mack GR (1981) Ulnar midcarpal instability—clinical and laboratory analysis. J Hand Surg Am 6:515–523
Kandel RA, Gross AE, Ganel A, McDermott AG, Langer F, Pritzker KP (1985) Histopathology of failed osteoarticular shell allografts. Clin Orthop Relat Res 197:103–110
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Mei, GH., Wang, HM., Fan, CY. et al. Possibility of the hamatum carpometacarpal joint as a new joint donor site for interphalangeal joint restoration. Eur J Orthop Surg Traumatol 24, 1175–1180 (2014). https://doi.org/10.1007/s00590-013-1300-4
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DOI: https://doi.org/10.1007/s00590-013-1300-4