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

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