Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
J Hand Surg Am. 2020 Jan;45(1):69.e1-69.e7. doi: 10.1016/j.jhsa.2019.05.013. Epub 2019 Jul 9.
To quantify the similarity of the surface topography of the proximal hamate and proximal pole of the scaphoid for nonunion reconstruction.
Using previously acquired computed tomographic scans of the wrist of 10 patients, the 2 bones were segmented and subsequently aligned using both a manual and automated technique. Surface error between corresponding articular surfaces was computed to determine the similarity of the shape of the 2 bones.
The median distance between the 2 articulating surfaces for each patient was 1 mm or less for all cases. Maximum distance varied from 2.7 to 9.7 mm. The automated method improved alignment such that the maximum distance was 4.1 mm. Visual review of the alignment revealed that the maximum error occurred on or around the margin of the articulating surfaces.
In most cases, the proximal hamate appears to be a suitable donor match to reconstruct proximal pole scaphoid nonunions.
This study serves as a guide to practitioners when considering the suitability of the proximal hamate autograft for unsalvageable proximal pole scaphoid nonunions.
定量分析近端舟状骨和月骨近端骨折不愈合重建的表面形貌相似度。
使用 10 例患者先前获得的腕关节计算机断层扫描，对 2 块骨头进行分割，然后使用手动和自动技术进行对齐。计算相应关节面之间的表面误差，以确定 2 块骨头形状的相似性。
对于所有病例，每个患者的 2 个关节面之间的中位数距离均为 1 毫米或以下。最大距离从 2.7 毫米到 9.7 毫米不等。自动方法改善了对齐，使得最大距离为 4.1 毫米。对齐的目视检查显示，最大误差发生在关节面的边缘或周围。
在大多数情况下，近端舟状骨似乎是重建近端月骨骨折不愈合的合适供体匹配物。
本研究为医生在考虑近端舟状骨自体移植物是否适合治疗无法挽救的近端月骨骨折不愈合时提供了指导。
