Relationship Between Carpal Bone Morphology and Distal Radius Fracture Pattern

Yıl 2022, Cilt: 12 Sayı: 6, 901 - 906, 30.11.2022

Tamer Coşkun Hasan Arık Sertaç Meydaneri

https://doi.org/10.16899/jcm.1174520

Öz

Abstract
Background: In this study, we examined whether carpal bones (lunate, hamate, capitate) morphologies and fourth metecarp-capitate articulation have an effect on the distal radius fracture pattern.

Methods: 206 patients who applied to the emergency department with distal radius fracture between 2016-2020 were included in the study. Preoperative and pre-reduction x-ray films of the patients were examined. Lunate, hamate, capitate morphologies and 4.metacarp articulation analyzed and classified. Distal radius fracture types were classified according to AO and Fernandez. The relationship between carpal bone morphology and distal radius fracture type was analyzed.

Results: This study consisted of 101 men and 103 women. AO fracture types and carpal bone morphologies (lunate joint type according to Viegas, lunate type according to Zapico, capitate morphology, hamate morphology and capitate-4 metacarpal joint morphology) did not differ significantly (p > 0.05). Fernandez fracture types and carpal bone morphologies (lunate joint type according to Viegas, lunate type according to Zapico, capitate morphology, hamatum morphology and capitate-4.metacarp joint morphology) were compared, there was no significant difference (p > 0.05).
Conclusion: As a result, no clear relationship could be demonstrated between carpal bone morphology and distal radius fracture pattern.

Anahtar Kelimeler

carpal morhology, distal radius fracture, fracture type

Karpal kemik morfolojisi ile distal radius kırık paterni arasındaki ilişki

Öz

Öz
Amaç: Bu çalışmada, karpal kemiklerin (lunate, hamate, kapitat) morfolojilerinin ve dördüncü metekarp-kapitat artikülasyonunun distal radius kırık paterni üzerinde bir etkisi olup olmadığını inceledik.

Gereç ve Yöntem: 2016-2020 yılları arasında acil servise distal radius kırığı ile başvuran 206 hasta çalışmaya dahil edildi. Hastaların ameliyat öncesi ve redüksiyon öncesi röntgen filmleri incelendi. Lunat, hamate, kapitat morfolojileri ve 4.metacarp artikülasyonu analiz edilerek sınıflandırıldı. Distal radius kırık tipleri AO ve Fernandez'e göre sınıflandırıldı. Karpal kemik morfolojisi ile distal radius kırığı tipi arasındaki ilişki analiz edildi.

Bulgular: Bu çalışmaya 101 erkek ve 103 kadın dahil edildi. AO kırık tipleri ve karpal kemik morfolojileri (Viegas'a göre lunat eklem tipi, Zapico'ya göre lunat tipi, kapitat morfolojisi, hamat morfolojisi ve kapitat-4 metakarpal eklem morfolojisi) anlamlı farklılık göstermedi (p > 0.05). Fernandez kırık tipleri ve karpal kemik morfolojileri (Viegas'a göre lunat eklem tipi, Zapico'ya göre lunat tip, kişi morfolojisi, hamatum morfolojisi ve kapitat-4.metacarp eklem morfolojisi) karşılaştırıldığında, anlamlı bir fark yoktu (p > 0.05).
Sonuç: Sonuç olarak, karpal kemik morfolojisi ile distal radius kırık paterni arasında net bir ilişki gösterilememiştir.

Anahtar Kelimeler

karpal morfoloji, distal radius kırığı, kırık tipi

Kaynakça

• 1.Viegas SF, Wagner K, Patterson R, Peterson P. Medial (hamate) facet of the lunate. J Hand Surg Am. 1990 Jul;15(4):564-71. doi: 10.1016/s0363-5023(09)90016-8. PMID: 2380518.
• 2.Antuno-Zapico J. Malacia del semilunar. Tesis doctoral. Universidad de Valladolid. Industrias y Editorial Sever Cuesta, Valladolid. 1966.
• 3.Yazaki N, Burns ST, Morris RP, Andersen CR, Patterson RM, Viegas SF. Variations of capitate morphology in the wrist. J Hand Surg Am. 2008 May-Jun;33(5):660-6. doi: 10.1016/j.jhsa.2008.02.002. PMID: 18590848.
• 4.Wollstein R, Rubinstein R, Friedlander S, Werner F. Capitate and Lunate Morphology in Normal Wrist Radiographs-A Pilot Study. Curr Rheumatol Rev. 2020;16(3):210-214. doi: 10.2174/1573397115666181205165642. PMID: 30520379.
• 5.Viegas SF, Crossley M, Marzke M, Wullstein K. The fourth carpometacarpal joint. J Hand Surg Am. 1991 May;16(3):525-33. doi: 10.1016/0363-5023(91)90026-8. PMID: 1861038.
• 6.McLean JM, Bain GI, Watts AC, Mooney LT, Turner PC, Moss M. Imaging recognition of morphological variants at the midcarpal joint. J Hand Surg Am. 2009 Jul-Aug;34(6):1044-55. doi: 10.1016/j.jhsa.2009.03.002. Epub 2009 Jun 4. PMID: 19497684.
• 7.Haase SC, Berger RA, Shin AY. Association between lunate morphology and carpal collapse patterns in scaphoid nonunions. J Hand Surg Am. 2007 Sep;32(7):1009-12. doi: 10.1016/j.jhsa.2007.06.005. PMID: 17826554.
• 8.Kim BJ, Kovacevic D, Lee YM, Seol JH, Kim MS. The Role of Lunate Morphology on Scapholunate Instability and Fracture Location in Patients Treated for Scaphoid Nonunion. Clin Orthop Surg. 2016 Jun;8(2):175-80. doi: 10.4055/cios.2016.8.2.175. Epub 2016 May 10. PMID: 27247743; PMCID: PMC4870321.
• 9.Rhee PC, Moran SL, Shin AY. Association between lunate morphology and carpal collapse in cases of scapholunate dissociation. J Hand Surg Am. 2009 Nov;34(9):1633-9. doi: 10.1016/j.jhsa.2009.06.017. Epub 2009 Oct 14. PMID: 19833447.
• 10.Pang EQ, Douglass N, Kamal RN. Association of Lunate Morphology With Carpal Instability in Scapholunate Ligament Injury. Hand (N Y). 2018 Jul;13(4):418-422. doi: 10.1177/1558944717709073. Epub 2017 May 19. PMID: 28525962; PMCID: PMC6081780.
• 11.Hintringer W, Rosenauer R, Pezzei C, Quadlbauer S, Jurkowitsch J, Keuchel T, Hausner T, Leixnering M, Krimmer H. Biomechanical considerations on a CT-based treatment-oriented classification in radius fractures. Arch Orthop Trauma Surg. 2020 May;140(5):595-609. doi: 10.1007/s00402-020-03405-7. Epub 2020 Mar 19. PMID: 32193681; PMCID: PMC7181558.
• 12.Bunch PM, Sheehan SE, Dyer GS, Sodickson A, Khurana B. A biomechanical approach to distal radius fractures for the emergency radiologist. Emerg Radiol. 2016 Apr;23(2):175-85. doi: 10.1007/s10140-015-1363-0. Epub 2015 Nov 12. PMID: 26564022.
• 13.Baumbach SF, Dall'Ara E, Weninger P, Antoni A, Traxler H, Dörr M, Zysset PK. Assessment of a novel biomechanical fracture model for distal radius fractures. BMC Musculoskelet Disord. 2012 Dec 18;13:252. doi: 10.1186/1471-2474-13-252. PMID: 23244634; PMCID: PMC3557151.
• 14.Rhee PC, Jones DB, Moran SL, Shin AY. The effect of lunate morphology in Kienböck disease. J Hand Surg Am. 2015 Apr;40(4):738-44. doi: 10.1016/j.jhsa.2014.12.024. Epub 2015 Feb 18. PMID: 25701489.
• 15.Kato H, Nakamura R. Lunate Morphology of Kienböck's Disease on X-Ray Study. Hand Surg. 1999 Jul;4(1):75-79. doi: 10.1142/s0218810499000137. PMID: 11089160.
• 16.Tatebe M, Imaeda T, Hirata H. The impact of lunate morphology on Kienböck's disease. J Hand Surg Eur Vol. 2015 Jun;40(5):534-6. doi: 10.1177/1753193413491235. Epub 2013 May 27. PMID: 23711924.
• 17.Elsaftawy A, Jabłecki J, Gworys B, Domanasiewicz A. Radiological and anatomical study to investigate possibility of relationship between scaphoid fracture and lunate morphology. Ortop Traumatol Rehabil. 2013 Jul-Aug;15(4):305-14. doi: 10.5604/15093492.1073829. PMID: 24431268.
• 18.Huang JI, Thayer MK, Paczas M, Lacey SH, Cooperman DR. Variations in Hook of Hamate Morphology: A Cadaveric Analysis. J Hand Surg Am. 2019 Jul;44(7):611.e1-611.e5. doi: 10.1016/j.jhsa.2018.08.007. Epub 2018 Oct 2. PMID: 30287099.
• 19.McLean J, Bain G, Eames M, Fogg Q, Pourgiezis N. An anatomic study of the triquetrum-hamate joint. J Hand Surg Am. 2006 Apr;31(4):601-7. doi: 10.1016/j.jhsa.2005.11.007. PMID: 16632054.
• 20.Tang P, Swart E, Konopka G, Raskolnikov D, Katcherian C. Effect of capitate morphology on contact biomechanics after proximal row carpectomy. J Hand Surg Am. 2013 Jul;38(7):1340-5. doi: 10.1016/j.jhsa.2013.03.054. Epub 2013 Jun 6. PMID: 23746398.
• 21.Rundgren J, Bojan A, Mellstrand Navarro C, Enocson A. Epidemiology, classification, treatment and mortality of distal radius fractures in adults: an observational study of 23,394 fractures from the national Swedish fracture register. BMC Musculoskelet Disord. 2020 Feb 8;21(1):88. doi: 10.1186/s12891-020-3097-8. PMID: 32035488; PMCID: PMC7007648.
• 22.Mauck BM, Swigler CW. Evidence-Based Review of Distal Radius Fractures. Orthop Clin North Am. 2018 Apr;49(2):211-222. doi: 10.1016/j.ocl.2017.12.001. PMID: 29499822.
• 23.Hung LK, Wu HT, Leung PC, Qin L. Low BMD is a risk factor for low-energy Colles' fractures in women before and after menopause. Clin Orthop Relat Res. 2005 Jun;(435):219-25. doi: 10.1097/01.blo.0000155345.04782.14. PMID: 15930942.