Upper Extremity and Reconstructive Unit, Institute of Orthopaedics, Lerdsin Hospital, Department of Orthopaedic Surgery, College of Medicine, Rangsit University, Bangkok, Thailand.
J Hand Surg Asian Pac Vol. 2021 Jun;26(2):240-244. doi: 10.1142/S2424835521500259.
Hemi-hamate arthroplasty is one of the treatment options for dorsal proximal interphalangeal joint fracture dislocation. Many studies reported favorable outcomes. However, some long term studies demonstrated the degenerative change of PIP joint. The articular mismatch of the hemi-hamate autograft might play an important role of this complication. We studied the anatomy of distal articular surface of the hamate bone in embalmed hamate bones. The anatomy of distal articular surface and dimensions of the hamate bone were measured and recorded. Seventy hamate bones were dissected out from embalmed cadavers and included in this study. The mean angle of the 4 metacarpal articulation was 85.54 degrees (SD = 3.53) and mean angle of the 5 metacarpal articulation was 95.51 degrees (SD = 3.57). The inter-articular ridge was approximately 5 degrees radial inclination. The inter-articular ridge of distal articular surface was approximately 5 degrees radial inclination. In order to minimize the graft mismatch, we recommend making the bone cut with the saw blade tilted to radial side 5 degrees to achieve better alignment of inter-articular ridge of the graft.
半钩骨关节成形术是治疗背侧近节指间关节骨折脱位的方法之一。许多研究报告了良好的结果。然而，一些长期研究显示了 PIP 关节的退行性变化。半钩骨自体移植物的关节不匹配可能在这种并发症中起重要作用。我们研究了防腐处理后的钩骨远端关节面的解剖结构。测量并记录了钩骨远端关节面的解剖结构和尺寸。本研究共解剖了 70 个防腐处理后的钩骨。第 4 掌骨关节的平均角度为 85.54 度（标准差=3.53），第 5 掌骨关节的平均角度为 95.51 度（标准差=3.57）。关节间嵴有大约 5 度的桡侧倾斜。远端关节面的关节间嵴有大约 5 度的桡侧倾斜。为了最小化移植物不匹配，我们建议用锯片向桡侧倾斜 5 度进行骨切割，以实现更好的关节间嵴对齐。
