Keller Marco, Rueegg Jasmine, Haefeli Mathias, Honigmann Philipp
Hand and Peripheral Nerve Surgery, Department of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland (Bruderholz, Liestal, Laufen), 4101 Bruderholz, Switzerland.
Hand and Peripheral Nerve Surgery, Department of Orthopaedic Surgery, Traumatology and Hand Surgery, Spital Limmattal, 8952 Schlieren, Switzerland.
J Clin Med. 2024 Sep 18;13(18):5513. doi: 10.3390/jcm13185513.
Numerous anatomical features of the first carpometacarpal (CMC I) joint have been investigated as potential predispositions for CMC I osteoarthritis (OA). Even though load transmission through the CMC I joint-and, therefore, the development of osteoarthritis-is believed to be influenced by the geometry of the first metacarpal (MC I) bone, there is no common definition of the MC I axes. CT scans of twenty healthy volunteers and pre- and postoperative CT scans of six patients with CMC I OA undergoing Wilson osteotomy were analyzed. We proposed a calculation method based on anatomical landmarks for the proximal joint surface axis (PA) angle and the definition of an anatomical (AA) and a mechanical (MA) longitudinal axis. We hypothesized that for an MC I extension osteotomy to be effective, the AA and MA need to be aligned surgically. : To align AA and MA, an average correction angle of 22.60° (SD 2.53°) at 1 cm and 26.73° (SD 2.55°) at 1.5 cm distal to the CMC I joint line is required. The hereby proposed method for patient-specific calculation of the correction can be used to improve the surgical technique.
第一掌腕关节（CMC I）的许多解剖特征已被研究，作为CMC I骨关节炎（OA）的潜在易患因素。尽管通过CMC I关节的负荷传递以及因此骨关节炎的发展被认为受第一掌骨（MC I）骨的几何形状影响，但对于MC I轴尚无统一的定义。分析了20名健康志愿者的CT扫描以及6例接受威尔逊截骨术的CMC I OA患者的术前和术后CT扫描。我们提出了一种基于解剖标志的计算方法，用于计算近端关节面轴（PA）角以及定义解剖学（AA）和力学（MA）纵轴。我们假设，对于MC I伸展截骨术要有效，AA和MA需要在手术中对齐。为了使AA和MA对齐，在CMC I关节线远端1 cm处平均矫正角度为22.60°（标准差2.53°），在1.5 cm处为26.73°（标准差2.55°）。本文提出的针对患者的矫正计算方法可用于改进手术技术。
