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Morphometric Comparison of Distal Hamate Articular Surface with the Proximal Articular Surface of Middle Phalanges of Index, Middle, Ring and Little Fingers for Hemi-Hamate Arthroplasty

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2 /by traumaadmin

Vol 8 | Issue 2 | July-December 2022 | page: 13-16 | Monish N DOI: https://doi.org/10.13107/ti.2022.v08i02.028 Authors: Monish N [1] [1] Department of Orthopedic, KMC Hospital, Mangalore, Karnataka, India. Address of Correspondence Dr. Monish N Department of Orthopedic, KMC Hospital, Mangalore, Karnataka, India. E-mail: monish1994n@gmail.com Abstract PURPOSE: The study is focused to compare the Distal […]

A Comparative Study showing Elbow Kinematics in Radial Head Replacement Versus Radial Head Excision Versus Radial Head Fixation

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2 /by traumaadmin

Vol 8 | Issue 2 | July-December 2022 | page: 01-05 | Amit Yadav, Sagar Bansal, Mrinal Kambli, Shaswat Mishra, Devenshu Gupta DOI: https://doi.org/10.13107/ti.2022.v08i02.026 Authors: Amit Yadav [1], Sagar Bansal [1], Mrinal Kambli [1], Shaswat Mishra [1], Devenshu Gupta [1] [1] Department of Orthopaedics, Grant Medical College and Sir J. J. Group of Hospitals, Byculla, […]

Morphometric Comparison of Distal Hamate Articular Surface with the Proximal Articular Surface of Middle Phalanges of Index, Middle, Ring and Little Fingers for Hemi-Hamate Arthroplasty

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2 /by traumaadmin

A Comparative Study showing Elbow Kinematics in Radial Head Replacement Versus Radial Head Excision Versus Radial Head Fixation

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2 /by traumaadmin

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Morphometric Comparison of Distal Hamate Articular Surface with the Proximal Articular Surface of Middle Phalanges of Index, Middle, Ring and Little Fingers for Hemi-Hamate Arthroplasty

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2 /by traumaadmin

Vol 8 | Issue 2 | July-December 2022 | page: 13-16 | Monish N

DOI: https://doi.org/10.13107/ti.2022.v08i02.028

Authors: Monish N [1]

[1] Department of Orthopedic, KMC Hospital, Mangalore, Karnataka, India.

Address of Correspondence

Dr. Monish N

Department of Orthopedic, KMC Hospital, Mangalore, Karnataka, India.

E-mail: monish1994n@gmail.com

Abstract

PURPOSE: The study is focused to compare the Distal Hamate articular Surface to the morphology of the base of middle phalanges of Index, Middle, Ring & little fingers.

METHODOLOGY: A Observational Paired T study was conducted. Patients with fractures of forearm or hand excluding any fractures in hamate and middle phalanges of Index , Middle, Ring & Little finger of both the upper limbs are subjected to Computed Tomography (CT) of hand and a 3D reconstructed image is obtained. Once the scans are collected, the below parameters will be determined using Radiant software.

RESULTS: At the end of this study ,we found that Majority of the patients who underwent CT Scans were noted to be between 31 and 50 years of age. Gender wise, males considered for the study were 24 (52%) and females were 25 (49%). The average hamate axial ridge angle was 69.18 and that of the ring finger middle phalangeal base was 80.23 (P < .05) Out of 50 patients the axial ridge angle of hamate was comparable with ring finger middle phalangeal base. The average distal hamate surface area was 1.04 and that of the middle phalangeal base was 1.00 (P < .05) The distal hamate articular surface area was comparable with the middle finger’s middle phalangeal base. The average sagittal inclination of distal hamate surface was 48.64 and that of the ring finger middle phalangeal base was 49.08 (P < .05) . The sagittal inclination of hamate was comparable with ring finger middle phalangeal base .

CONCLUSION: In literature very few radiological studies comparing the hamate and middle phalanx articular surfaces are reported. This study helps us in understanding the digit which is similar to hamate for undergoing Hemi Hamate Arthroplasty and usefulness of pre operative CT scan in further management of chronic proximal interphalangeal joint fracture dislocations. According to the results obtained from our study, we conclude that the Axial ridge angle and sagittal inclination of Middle Phalanx of Ring finger is in close approximation with Hamate . Articular Surface Area of Middle Finger is in close approximation with Hamate distal articular surface area.

Keywords: PIPJ- Proximal Interphalangeal Joint, ORIF- Open Reduction, Interal Fixation, CT- Computed Tomography, HHA- Hemi Hamate Arthroplasty

References

1.Drain J, Mehta S, Goyal KS. An analysis of hamate morphology relevant to Hemi-hamate arthroplasty. J Hand Surg Am [Internet]. 2020;45(7):657.e1-657.e6

2. Sollaccio DR, Navo P, Ghiassi A, Orr CM, Patel BA, Lewton KL. Evaluation of articular surface similarity of Hemi-hamate grafts and proximal middle phalanx morphology: A 3D geometric morphometric approach. J Hand Surg Am [Internet]. 2019;44(2):121–8.

3. Calva, D., Calotta, N., Lopez, J., Christopher, A., Magid, D., Demehri, S., & Lifchez, S. D. (2016). A simple pre-operative imaging method to assess donor and recipient anatomy in hemi-hamate arthroplasty for proximal interphalangeal joint reconstruction. Surgical and Radiologic Anatomy, 38(6), 699-704.

4. Ten Berg P, Ring D. Quantitative 3D-CT anatomy of hamate osteoarticular autograft for reconstruction of the middle phalanx base. Clin Orthop Relat Res [Internet]. 2012;470(12):3492–8.

5. McAuliffe JA. Hemi-hamate autograft for the treatment of unstable dorsal fracture dislocation of the proximal interphalangeal joint. J Hand Surg Am [Internet]. 2009;34(10):1890–4.

6. Calfee, R. P., Kiefhaber, T. R., Sommerkamp, T. G., & Stern, P. J. (2009). Hemi-hamate arthroplasty provides functional reconstruction of acute and chronic proximal interphalangeal fracture–dislocations. The Journal of hand surgery, 34(7), 1232-1241.

7. Capo JT, Hastings H 2nd, Choung E, Kinchelow T, Rossy W, Steinberg B. Hemicondylar hamate replacement arthroplasty for proximal interphalangeal joint fracture dislocations: an assessment of graft suitability. J Hand Surg Am [Internet]. 2008;33(5):733–9.

8. Barksfield RC, Bowden B, Chojnowski AJ. Hemi-hamate arthroplasty versus transarticular Kirschner wire fixation for unstable dorsal fracture-dislocation of the proximal interphalangeal joint in the hand. Hand Surg [Internet]. 2015;20(1):115–9.

9. Korambayil PM, Francis A. Hemi-hamate arthroplasty for pilon fractures of finger. Indian J Plast Surg [Internet]. 2011;44(3):458–66.

10. Podolsky DJ, Mainprize J, McMillan C, Binhammer P. Suitability of using the hamate for reconstruction of the finger middle phalanx base: An assessment of cartilage thickness. Plast Surg (Oakv) [Internet]. 2019;27(3):211–6.

11. Williams RMM, Kiefhaber TR, Sommerkamp TG, Stern PJ. Treatment of unstable dorsal proximal interphalangeal fracture/dislocations using a hemi-hamate autograft. J Hand Surg Am [Internet]. 2003;28(5):856–65.

12. Janssen, S. J., Ter Meulen, D. P., Hageman, M. G., Earp, B. E., & Ring, D. (2015). Quantitative 3-dimensional CT analyses of fractures of the middle phalanx base. HAND, 10(2), 210-214.

How to Cite this article: Monish N | Morphometric Comparison of Distal Hamate Articular Surface with the Proximal Articular Surface of Middle Phalanges of Index, Middle, Ring and Little Fingers for Hemi-Hamate Arthroplasty | July-December 2022; 8(2): 13-16 https://doi.org/10.13107/ti.2022.v08i02.028

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A Comparative Study showing Elbow Kinematics in Radial Head Replacement Versus Radial Head Excision Versus Radial Head Fixation

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2 /by traumaadmin

Vol 8 | Issue 2 | July-December 2022 | page: 01-05 | Amit Yadav, Sagar Bansal, Mrinal Kambli, Shaswat Mishra, Devenshu Gupta

DOI: https://doi.org/10.13107/ti.2022.v08i02.026

Authors: Amit Yadav [1], Sagar Bansal [1], Mrinal Kambli [1], Shaswat Mishra [1], Devenshu Gupta [1]

[1] Department of Orthopaedics, Grant Medical College and Sir J. J. Group of Hospitals, Byculla, Mumbai, Maharashtra, India.

Address of Correspondence
Dr Sagar Bansal,
Senior Resident, Department of Orthopaedics, Grant Medical College and Sir J. J. Group of Hospitals, Byculla, Mumbai, Maharashtra, India.

E-mail: sagarbansal59@gmail.com

Abstract

Background: Radial head fractures are quite common with incidence 1.5-4% of all adult fractures. The management of these fractures depends upon age and type of injury

Aim: To compare the outcome in comminuted radial head fractures(Mason type III) based on mayo elbow scoring and handgrip strength test when managed with radial head excision, radial head fixation or radial head replacement

Material and Methods: We did a prospective comparative study comprising 60 patients between age 20-60 years with Mason type III radial head fractures. The patients were randomised using the admission day of the week placing 20 patients each in arthroplasty , excision and in the fixation group. The patients were followed up for 18-24 months postoperatively. Results were evaluated by the Mayo’s elbow performance and Handgrip strength score at 6 months and 18 months and were statistically evaluated by one-way ANOVA test.

Results: As per Mayo’s score at 6 months follow up, mean and standard deviation (SD) of the scores in arthroplasty was 83.25 and 11.50, for excision it was 76.25 and 11.38 & for fixation, it was 68.75 and 17.83 respectively. At 18 months follow up, mean and standard deviation was 90 and 12.56 for arthroplasty, 83 and 9.92 for excision & 76.25 and 21.69 for fixation respectively. As per handgrip strength score at 6 months follow up, mean and standard deviation of the scores in arthroplasty was 31.1 and 4.37, for excision it was 28.75 and 4.27 & for fixation, it was 27.15 and 5.94 respectively. At 18 months follow up, mean and standard deviation was 32.95 and 4.006 for arthroplasty, 30.7 and 4.06 for excision & 28 and 6.75 for fixation respectively. The difference between the results according to both Mayo’s score as well as Handgrip strength test was statistically significant (p < 0.05).

Conclusion: Our study shows that long and short-term results of radial head replacement are better than radial head excision and radial head fixation in comminuted radial head fractures based on mayo elbow scoring and hand grip strength score.

Keywords: Radial head fracture, Radial head replacement, Mason classification

References

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2. Broberg MA, Morrey BF. Results of treatment of fracture-dislocations of the elbow. Clin Orthop. 1987;216:109-19.

3. Mason ML. Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg. 1954;42:123-32.

4. Johnston GW. A follow-up of one hundred cases of fracture of the head of the radius with a review of the literature. Ulster Med J. 1962; 31:51-6.

5. Putz R, Milz S, Maier M, Boszczyk A. Functional morphology of the elbow joint. Orthopade. 2003; 32:684-90. 6. Kapandji IA. The Physiology of the Joints. Vol. 1. Edinburgh, London: E&S Livingstone, 1970:84.

7. Ring, David MD; Psychoyios, Vasilis N. MD; Chin, Kingsley R. MD; Jupiter, Jesse B. MD Nonunion of Nonoperatively Treated Fractures of the Radial Head, Clinical Orthopaedics and Related Research: May 2002 – Volume 398 – Issue – p 235-238.

8. Yamaguchi K, Sweet FA, Bindra R, Morrey BF, Gelberman RH: The extraosseous and intraosseous arterial anatomy of the adult elbow. J Bone Joint Surg 79A:1653–1662, 1997.

9. Singh AK, Jidge A, Ramteke U, Venkateswaran N, Rokade H, Mulje SM, Mukherjee S, Kotian A. Functional Outcome of Elbow Kinematics in Radial Head Excision Versus Radial Head Replacement: A Comparative Study. Open Access Maced J Med Sci. 2019 May 15;7(9):1505-1508.

10. Beingessner DM, Dunning CE, Gordon KD, Johnson JA, King GJ. The effect of radial head excision and arthroplasty on elbow kinematics and stability. J Bone Joint Surg Am. 2004 Aug;86(8):1730-9.

11. Ikeda M, Sugiyama K, Kang C, Takagaki T, Oka Y. Comminuted fractures of the radial head: comparison of resection and internal fixation. Surgical technique. J Bone Joint Surg Am. 2006 Mar;88 Suppl 1 Pt 1:11-23.

12. Swensen SJ, Tyagi V, Uquillas C, Shakked RJ, Yoon RS, Liporace FA. Maximizing outcomes in the treatment of radial head fractures. J Orthop Traumatol. 2019 Mar 23;20(1):15.

13. Sun H, Duan J, Li F. Comparison between radial head arthroplasty and open reduction and internal fixation in patients with radial head fractures (modified Mason type III and IV): a meta-analysis. Eur J Orthop Surg Traumatol. 2016 Apr;26(3):283-91.

14. Sinha S, Sarkar S, Singh A, Saraf SK, Rastogi A, Singh T. Radial Head Arthroplasty, Excision and Osteosynthesis in Complex Elbow Fracture-Dislocations in Young Adults: What is Preferred? Indian J Orthop. 2020 May 18;54(Suppl 2):260-269.

15. Heim U.[Combined fractures of the radius and the ulna at the elbow level in the adult. Analysis of 120 cases after more than 1 year]. Rev Chir Orthop Reparatrice Appar Mot. 1998 Apr;84(2):142-53.

16. Ring D, Quintero J, Jupiter JB. Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am. 2002 Oct;84(10):1811-5.

17. Herbertsson P, Josefsson PO, Hasserius R, Besjakov J, Nyqvist F, Karlsson MK. Fractures of the radial head and neck treated with radial head excision. J Bone Joint Surg Am. 2004 Sep;86(9):1925-30.

18. Shetty SK, Shetty A, Balan B, Ballal A, Rai HR, Hegde A. Excision Versus Fixation of the Radial Head: A Comparative Study of the Functional Outcomes of the Two Techniques. J Clin Diagn Res. 2017 Feb;11(2):RC01-RC03.

19. Bain GI, Ashwood N, Baird R, Unni R. Management of Mason type-III radial head fractures with a titanium prosthesis, ligament repair, and early mobilization. Surgical technique. J Bone Joint Surg Am. 2005 Mar;87 Suppl 1(Pt 1):136-47.

How to Cite this article: Yadav A, Bansal S, Kambli M, Mishra S, Gupta D | A Comparative Study showing Elbow Kinematics in Radial Head Replacement Versus Radial Head Excision Versus Radial Head Fixation | July-December 2022; 8(2): 01-05. https://doi.org/10.13107/ti.2022.v08i02.026

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Morphometric Comparison of Distal Hamate Articular Surface with the Proximal Articular Surface of Middle Phalanges of Index, Middle, Ring and Little Fingers for Hemi-Hamate Arthroplasty

A Comparative Study showing Elbow Kinematics in Radial Head Replacement Versus Radial Head Excision Versus Radial Head Fixation

Morphometric Comparison of Distal Hamate Articular Surface with the Proximal Articular Surface of Middle Phalanges of Index, Middle, Ring and Little Fingers for Hemi-Hamate Arthroplasty

A Comparative Study showing Elbow Kinematics in Radial Head Replacement Versus Radial Head Excision Versus Radial Head Fixation

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Morphometric Comparison of Distal Hamate Articular Surface with the Proximal Articular Surface of Middle Phalanges of Index, Middle, Ring and Little Fingers for Hemi-Hamate Arthroplasty

Authors: Monish N [1]

Abstract

References

(Abstract Text HTML) (Download PDF)

A Comparative Study showing Elbow Kinematics in Radial Head Replacement Versus Radial Head Excision Versus Radial Head Fixation

Authors: Amit Yadav [1], Sagar Bansal [1], Mrinal Kambli [1], Shaswat Mishra [1], Devenshu Gupta [1]

Abstract

References

(Abstract Text HTML) (Download PDF)

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