Durand Sebastien, Dufour Justine, Rosas Antonio, Becce Fabio, Orr Caley
Department of Plastic and Hand Surgery, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.
Department of Paleobiology, National Museum of Natural Sciences, CSIC, Calle Jose Gutierrez Abascal 2, 28006 Madrid, Spain.
Diagnostics (Basel). 2021 Dec 7;11(12):2295. doi: 10.3390/diagnostics11122295.
In humans, bipartite scaphoid still does not differentiate clearly from traumatic non-union of the scaphoid. To aid diagnosis, we sought to analyze the main geometrical similarities among bipartite scaphoids from primate species with fused and unfused scaphoid centrales. Four human embryos, four cases of adult humans with bipartite scaphoid, twelve adult specimens of other extant anthropoid primates, and two Neandertal scaphoid specimens were included in this study. Three-dimensional polygon models of the scaphoid and os centrale were generated from CT scan, micro-CT scan, or histological sections. A 3D comparative study of the morphological and morphometrical parameters was performed using the MSC Patran software. The os centrale was smaller than the scaphoid in all specimens and its shape was elongated in the anteroposterior scaphoid direction. The position of the os centrale centroid compared to the scaphoid using direction vectors had a strong orientation along the proximodistal axis in all species. The main morphological feature of bipartite scaphoid was the continuity of the scaphoid from its proximal pole to its tubercule along the anteroposterior axis. In all specimens, if the os centrale was removed, the scaphoid still appeared normal and whole. The bipartite scaphoid in adult humans shares geometrical analogies with monkeys and orangutans, human embryos, and Neandertals. Morphological and morphometrical features identified in this study are useful to differentiate bipartite scaphoid from scaphoid pseudarthrosis. All other criteria suggested in the past lead to misdiagnosis.
在人类中，二分舟状骨与舟状骨创伤性不愈合仍难以明确区分。为辅助诊断，我们试图分析灵长类动物中二分舟状骨与融合和未融合的中央舟状骨之间的主要几何相似性。本研究纳入了4例人类胚胎、4例患有二分舟状骨的成年人类、12例其他现存类人猿灵长类动物的成年标本以及2例尼安德特人的舟状骨标本。通过CT扫描、显微CT扫描或组织切片生成舟状骨和中央骨的三维多边形模型。使用MSC Patran软件对形态学和形态测量参数进行三维比较研究。在所有标本中，中央骨均小于舟状骨，其形状在舟状骨的前后方向上呈细长形。使用方向向量比较中央骨质心与舟状骨的位置，在所有物种中，其在近远轴上具有很强的方向性。二分舟状骨的主要形态特征是舟状骨沿前后轴从近端极到结节的连续性。在所有标本中，如果去除中央骨，舟状骨仍显得正常且完整。成年人类的二分舟状骨与猴子、猩猩、人类胚胎和尼安德特人具有几何相似性。本研究中确定的形态学和形态测量特征有助于区分二分舟状骨与舟状骨假关节。过去提出的所有其他标准都会导致误诊。
