Department of Orthopaedics and Sports Medicine, University of South Florida, Tampa, Fl, USA.
Department of Molecular Medicine, University of South Florida, Tampa, Fl, USA.
Hand (N Y). 2021 Sep;16(5):706-713. doi: 10.1177/1558944719880026. Epub 2019 Oct 28.
Metacarpal factures are common, comprising up to 50% of hand fractures. More work is needed to further our understanding of metacarpal anatomy to improve fixation techniques and reduce postoperative complications following surgical implants. The purpose of this anatomic study was to evaluate the length, midshaft metaphyseal width, and area of the articular surface of the head (AH) and base (AB) of metacarpals 1 to 5. This prospective study assessed measures from 17 cadavers at 1 institution's anatomy lab. The anatomic dimensions of the metacarpals in both the right and left hands were measured. Epidemiological data including sex and age at death were also collected. In all, 29 hands were dissected for metacarpal anatomic measurements, for a total of 145 metacarpals. The second metacarpal was longest, at 69.58 mm. Multivariate analysis of variance revealed a significant effect of sex overall, with greater metacarpal dimensions in men. Increasing age was associated with decreasing dimensions, except for AH of metacarpal 1 ( = 3.43, = .02) and AB of metacarpal 1 ( = 11.54, < .001) and 4 ( = 4.21, = .01). Multiple metacarpal dimensions were also significantly correlated with each other. Our data reveal further information regarding metacarpal dimensions of length, midshaft width, and AH and AB. The results allow for potential to improve surgical management through improving metacarpal implants, developing an optimal plate and screw design, techniques to better accommodate anatomical differences based on age and sex, reducing postoperative complications and improving the standard of care.
掌骨骨折很常见，占手部骨折的 50%。为了进一步了解掌骨解剖结构，以改善固定技术并减少术后并发症，需要做更多的工作。本解剖研究的目的是评估第 1 至第 5 掌骨的头部（AH）和基部（AB）的关节面的长度、中轴骨干宽度和面积。这项前瞻性研究评估了来自 1 个机构解剖实验室的 17 个尸体的测量值。测量了右手和左手掌骨的解剖尺寸。还收集了包括死亡时性别和年龄在内的人口统计学数据。共解剖了 29 只手以进行掌骨解剖测量，总共 145 只掌骨。第二掌骨最长，为 69.58 毫米。多变量方差分析显示，总体上性别有显著影响，男性掌骨尺寸较大。年龄的增加与尺寸的减小有关，但第 1 掌骨的 AH（ = 3.43， =.02）和第 1 掌骨的 AB（ = 11.54， <.001）和第 4 掌骨的 AB（ = 4.21， =.01）除外。多个掌骨尺寸彼此之间也存在显著相关性。我们的数据提供了关于掌骨长度、骨干宽度以及 AH 和 AB 的进一步信息。结果为通过改进掌骨植入物、开发最佳的钢板和螺钉设计、基于年龄和性别的解剖差异的技术，以减少术后并发症和改善护理标准，从而改善手术管理提供了潜力。
