Scientific article
Morphometric Analysis of Potential Osteochondral Autografts for Resurfacing Unicondylar Defects of the Proximal Phalanx in PIP Joint Injuries

https://doi.org/10.1016/j.jhsa.2009.12.041Get rights and content

Purpose

This study was designed to morphometrically assess the base of the little and ring finger metacarpals as potential osteochondral donors to resurface distal condylar defects of the proximal phalanx.

Methods

The proximal phalanges were dissected from all 4 fingers in 10 cadaveric hands and the following measurements were obtained from the distal condylar surface: anteroposterior height, radial-ulnar width, and radius of curvature. Measurements were obtained from posteroanterior and lateral radiographic views, which were digitized and analyzed using digital imaging software. Comparable measurements were obtained from the base of the small and ring metacarpals.

Results

The anteroposterior dimension of both potential donor metacarpals was large enough to resurface the distal condyles of each of the proximal phalanges; however, this was not true for the radial-ulnar dimensions. The distal ulnar condyle of the long finger proximal phalanx was largest, measuring 4.9 (± 0.) mm dorsally and 6.2 (± 0.5) mm volarly in the radial-ulnar dimension. Only the small metacarpal base had sufficient stock in the radial-ulnar dimension (9.4 [± 1.7]) mm dorsally and 10.6 [± 2.0] mm volarly) to resurface this condyle. With respect to radius of curvature (ROC), the donor-to-recipient ROC ratio was 1.43 for the small metacarpal base versus 2.12 for the ring metacarpal base. Linear regression analysis revealed a stronger relationship in ROC between donor and recipient condyle when the small metacarpal base served as the donor (R = 0.96 vs R = 0.60).

Conclusions

As determined from morphometric measurements of the 2 potential donor sites tested, the base of the small metacarpal provides the best match for resurfacing distal condylar defects of the proximal phalanges.

Section snippets

Anatomical measurements

Ten fresh-frozen cadaveric hands were thawed and dissected to harvest the metacarpals and the proximal phalanges. The anteroposterior (AP; height), radial-ulnar (width), and radius of curvature (ROC) dimensions of the heads of the index, middle, ring and small finger proximal phalanges and the bases of the ring and small metacarpals were measured from posteroanterior (PA) and lateral radiographic views.

To ensure proper orientation of the harvested specimens, each bone was embedded in clay, each

Morphometry

Anteroposterior, radial-ulnar, and ROC dimensions for the index through little proximal phalangeal condyles and the little and ring metacarpal bases are shown in Table 1. The radial condylar dimensions were greater than the ulnar condylar dimensions for the ring and small fingers. The opposite was found for the index and long fingers. The largest condyle measured was the ulnar condyle of the long finger, and the smallest was the ulnar condyle of the small finger.

The anatomic dimensions of the

Discussion

In this investigation, the base of the small and ring finger metacarpals were morphometrically assessed as potential donors to replace 1 of the condyles of the proximal phalanx. Of the 2 potential donor grafts investigated, only the small metacarpal base demonstrated adequate graft material to resurface all dimensions of the largest phalangeal condyles. Both potential donors demonstrated adequate graft in the AP and dorsal radial-ulnar dimensions. When assessing volar width, however, only the

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