Lucenti Ludovico, Lutsky Kevin F, Banner Lauren, Lazev Zachary, Beredjiklian Pedro K
Department of Orthopaedics and Traumatology, University Hospital Policlinico Vittorio Emanuele, University of Catania, Catania, Italy.
Department of Orthopaedic Surgery Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Arch Bone Jt Surg. 2020 Jan;8(1):70-74. doi: 10.22038/abjs.2019.38351.2014.
The hemi-hamate arthroplasty (HHA) can restore joint congruity and stability in chronic fracture-dislocations of the proximal interphalangeal joint (PIPJ). Purpose of this study was to compare the width of the distal hamate articular surface (DHAS) to the width of the base of the middle phalanges (P2) of the fingers. We hypothesized the dimensions of the width of the DHAS would be similar to those of P2, leaving a small amount of residual DHAS width after autograft harvest.
Fifty-nine CT scans of the hand without any bony pathology were evaluated. Three observers measured the following parameters and compared: (a) Width of the DHAS in the axial and coronal planes; (b) Width of the P2 articular bases of all four fingers; (c) Maximum capitate length (MaxCap) in the coronal plane.
The residual DHAS on the coronal plane after graft harvest (bone remaining on the radial and ulnar aspects each, not accounting for saw blade or osteotomy width thickness) among all patients was 1.3, 0.9, 1.4, and 2.4 mm for the index, long, ring and small fingers respectively. There was a strong correlation between DHAS and MaxCap r=0.76.
There is likely to be a very small amount of residual hamate articular surface width left after the graft is harvested if the entire base of P2 is reconstructed.
半钩骨置换术（HHA）可恢复近端指间关节（PIPJ）慢性骨折脱位时的关节一致性和稳定性。本研究的目的是比较钩骨远端关节面（DHAS）的宽度与手指中节指骨（P2）基底的宽度。我们假设DHAS宽度的尺寸将与P2的尺寸相似，在自体骨移植取材后留下少量残余DHAS宽度。
对59例无任何骨质病变的手部CT扫描进行评估。三名观察者测量并比较了以下参数：（a）轴向和冠状面的DHAS宽度；（b）所有四个手指的P2关节基底宽度；（c）冠状面的最大头状骨长度（MaxCap）。
在所有患者中，移植取材后冠状面上的残余DHAS（桡侧和尺侧各保留的骨量，不考虑锯片或截骨宽度厚度），示指、中指、环指和小指分别为1.3、0.9、1.4和2.4毫米。DHAS与MaxCap之间存在强相关性，r = 0.76。
如果重建P2的整个基底，在移植取材后可能会留下非常少量的残余钩骨关节面宽度。
