Mei Guo-Hua, Wang Hai-Ming, Fan Cun-Yi, Zhang Chang-Qing, Zeng Bing-Fang
Department of Orthopaedic Surgery, Shanghai 6th People's Hospital, Shanghai Jiaotong University, Shanghai, 200233, China.
Eur J Orthop Surg Traumatol. 2014 Oct;24(7):1175-80. doi: 10.1007/s00590-013-1300-4. Epub 2013 Aug 28.
This research investigates the anatomic basis for the repair and reconstruction of hand joints using transposition of the carpometacarpal (CMC) joint of the hamatum.
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.
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 mm(2)) showed an evident difference.
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.
本研究探讨利用钩骨掌指关节(CMC)转位修复和重建手部关节的解剖学基础。
在上海第六人民医院显微外科研究所对22个新鲜冷冻的腕部标本观察钩骨CMC关节及中节指骨基部关节的形态和结构。测量关节的掌背径、桡尺径、凹陷深度和面积。通过统计分析获得数据,并从形态、结构、面积、长度和直径方面比较关节的相似性。
钩骨CMC关节的桡尺径(13.54±1.15mm)在食指、中指和环指的中节指骨以及拇指远节指骨中未显示出明显差异。钩骨CMC关节的掌背径(10.71±0.93mm)在环指中节指骨中显示出明显差异。在所有手指中,钩骨CMC关节的尺侧和桡侧凹陷深度(分别为1.30±0.08和0.95±0.05mm)以及钩骨CMC关节的面积(139.89±5.44mm²)均显示出明显差异。
钩骨CMC关节可被视为一个新的、可行的关节供体部位,可用于修复和重建中节指骨基部关节。