Nutrient Foramina Architecture In Metacarpal And Metatarsal Bones

Nutrient foramen (NF) conducts blood vessels which are chief nutritional source to bones. The anatomicalknowledge of nutrient foramina plays vital role in certain operative procedures to preserve the circulation.Details of NF in metacarpals and metatarsals is essential in reconstruction surgeries. This study designed toassess the architecture of nutrient foramina over metacarpal and metatarsal shafts. For this, a total 400metacarpal and 400 metatarsal bones were collected. All bones are examined for details of number, position,location and direction of nutrient foramina on shaft. Foraminal index was calculated by using Hughes formula.Majority bones are having single nutrient foramen (79.7% metacarpals, 79.5% metatarsals), double nutrientforamina was situated in very few metacarpals and metatarsals. Nutrient foramina are situated over medialsurface of 1st & 2nd metacarpals and 4th &5th metatarsal bones, whereas other bones have nutrient foramina overlateral surface of shaft. The anatomical and morphological details of nutrient foramina is beneficial for orthopedicand plastic surgeries during vascularized bone microsurgery and in bone grafts.

Macrodystrophia lipomatosis : a rare congenital anomaly.

Macrodystrophia Lipomatosis is rare congenital hamartomatous enlargement of soft tissue components leading to gigantism of single, multiple digits or entire limb. Clinical findings are recognised as early as in neonatal period to late adulthood. Patients usually present for either cosmetic corrections or mechanical problems. We report a case of 8 year old female with progressive increase in size of left 2nd and 3rd toes. X-ray findings show congenital focal enlargement of soft tissues and bones of 2nd and 3rd toes and adjacent metatarsals. Clinical and radiological features of our patient points out towards this uncommon condition.

Improve reconstructed metacarpophalangeal joint function with second toe transplantation after curved osteotomy under the metatarsal head cartilage / 中华显微外科杂志

ObjectiveTo investigate the technique and clinical results of curved osteotomy under the metatarsal head's cartilage for improving reconstructed metacarpophalangeal joint function of fingers with second toe transplantation. MethodsThere were total 21 cases with 21 digits. During second toe transplantation with the metatarsophalangeal joint, the bottom of the second metatarsal head was incised. Then a curved osteotomy were carried out on about 5.0 mm under the metatarsal head's cartilage until the passive range of motion could be 90°.Longitudinal or cross-Kirschner wires were used to fix the joint.Finally,the conventional methods were used to reconstruct the blood supply, movement and nerves. ResultsAll 21 digits of the 21 cases survived uneventfully.The follow-up time was ranged from 6 to 24 months.Their average passive range of motion of the reconstructed metacarpophalangeal joint was 75°,ranging from 65° to 85°.The average active range of motion was 65°, ranging from 45° to 80°. Postoperative X-ray revealed fracture healed well without joint degeneration. ConclusionCurved osteotomy under the metatarsal head's cartilage is an effective way to improve active and passive activities function of the reconstructed metacarpophalangeal joint with second toe transplantation.

One Stage Metatarsal Lengthening of Brachymetatarsia Involving Both 1st and 4th Metatarsal Bone (A case report) / 대한족부족관절학회지

19 years old girl presented with bilateral 1, 4th brachymetatarsia. We have used an autograft interposition technique to lengthen the brachymetatarsia involving first and fourth metatarsal. The technique was to graft the bone fragment from the relatively long second and third metatarsal bone to be used as an autograft to the short first and fourth metatarsal bone. The method is superior in not having the necessity of a long term external fixator which is needed using callotasis method and in also avoiding the inconvenience of performing an allograft. Absence of donor site complication during autograft from iliac bone is also an advantage to be mentioned. Our technique can therefore be ascertained as a successful method in both cosmetic results and improvement of symptoms including reduction in length of recovery.

Observations on Diaphysial Nutrient Foramina in Human Metatarsals / 체질인류학회지

One hundred ninety seven metatarsals of Korean adults were studied macroscopically for the number, position and direction of the diaphysial nutrient foramen. Most metatarsals had on diaphysial nutrient foramen which was situated in the middle third of the shaft with average foraminal index ranging from 43 to 51, but 73% of first metatarsals had two or more foramina. No foramen was observed in 3% of total metatarsals studied. Nutrient foramen was present most frequently on the lateral surface in the first and second metatarsals and on the medial surface in the fifth, but it was present about the same the rate on both medial and lateral surfaces in the third and forth. The direction of the foramen was toward the head in the first metatarsals and toward the basis in the rest being always away from the growing end, thus favoring the growing end theory.