| Quantitative 3D-CT anatomy of hamate osteoarticular autograft for reconstruction of the middle phalanx base. | |
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MedLine Citation:
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PMID: 22538961 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Hamate osteoarticular autografts are difficult to obtain and it is unclear to what degree the graft matches the joint surface to be replaced and whether a direct ulnar approach might provide a more reliable graft than the standard proximal to distal approach. PURPOSE: We modeled hemihamate osteotomies using quantitative three-dimensional CT (3D-CT) to measure the amount of hamate articular surface used and the match with the native volar base of the middle phalanx. METHODS: In virtual hemihamate osteotomies (standard and direct ulnar) on CTs of 20 patients (11 men and nine women), we measured the percentage of hamate articular surface used for each finger, the match of the articular contour, and the percentage of hamate articular surface removed. RESULTS: The autograft in the standard approach used an average of 26% of the hamate articular surface and had an average 75% match of the articular contour with the volar half of the middle phalanx base. A direct ulnar approach removed an additional small margin of dorsal ulnar hamate with an average maximum width of 2.5 mm and volume of 27 mm(3). CONCLUSIONS: An osteoarticular allograft from the hamate to replace the volar half of the middle phalanx base uses less than 1/3 of the hamate articular surface even if the dorsal ulnar margin of the hamate is taken with the graft. CLINICAL RELEVANCE: These data suggest that it might be feasible to make the deep cut from a direct ulnar approach. |
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Authors:
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Paul Ten Berg; David Ring |
Publication Detail:
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Type: Journal Article Date: 2012-04-27 |
Journal Detail:
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Title: Clinical orthopaedics and related research Volume: 470 ISSN: 1528-1132 ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-11-08 Completed Date: 2013-01-22 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 0075674 Medline TA: Clin Orthop Relat Res Country: United States |
Other Details:
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Languages: eng Pagination: 3492-8 Citation Subset: AIM; IM |
Affiliation:
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Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Massachusetts General Hospital, Yawkey 2100, 55 Fruit St, Boston, MA 02114, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Bone Transplantation* Computer Graphics Computer Simulation Female Finger Phalanges / radiography*, surgery* Hamate Bone / radiography*, transplantation* Humans Imaging, Three-Dimensional* Male Middle Aged Models, Anatomic Osteotomy Predictive Value of Tests Radiographic Image Interpretation, Computer-Assisted* Reconstructive Surgical Procedures Surgery, Computer-Assisted Tomography, X-Ray Computed* Transplantation, Autologous Ulna / surgery Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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