Analysis of Wrist Morphology Through Hamate and Lunate Bone Variations in Anatolian Population Using Plain Radiography / Análisis de la Morfología de la Articulación Radiocarpiana a Través de las Variaciones de los Huesos Hamato y Semilunar en la Población de Anatolia Mediante Radiografía Simple

SUMMARY: The present study aimed to evaluate wrist (lunate) anatomy in terms of the incidence of lunatum morphology on plain-radiographs among the Anatolian (Turkey) population, accompanied by demographic analysis. We obtained all the patients' data regarding demographical features, diagnosis, and posteroanterior (PA) X-ray imaging. Two radiograph-reviewers repeated the analysis twice, one month later, blinded to their findings before the previous review. The lunatum structure was determined as Type-1 (n:293) and Type-2 (n:207) for each radiograph. Most of the 500 wrists' radiographs [n:293 (58.6 %)] were type-I lunate. The mean age was 36.7±13.3 (range:18-90) years. Sex distribution was as follows: 185 (63.1 %) males to 108 (36.9 %) females. Type-2 lunate was seen in 207 participants (41.4 %). The mean age for type-2 was 41.6±15.2 (18-88) years. 142 (68.6 %) participants were male sex, while 65 (31.4 %) were females. The mean age of subjects with type-I showed a difference with type-II (p=0.007). There was no relationship in terms of sex (p=0.206) between the groups. In the Anatolian region, type-1 lunate was dominant compared to type-2. The incidence rate of lunate type in Anatolian population was similar to the Arab population.

El presente estudio tuvo como objetivo evaluar la anatomía de la articulación radiocarpiana en términos de la incidencia de la morfología del hueso semilunar en radiografías simples entre la población de Anatolia (Turquía), acompañado de un análisis demográfico. Obtuvimos todos los datos de los pacientes con respecto a las características demográficas, el diagnóstico y las imágenes de rayos X posteroanteriores (PA). Dos revisores de radiografías repitieron el análisis dos veces, un mes después, sin conocer sus hallazgos antes de la revisión anterior. La estructura del lunatum se determinó como Tipo-1 (n:293) y Tipo-2 (n:207) para cada radiografía. La mayoría de las 500 radiografías de muñecas [n:293 (58,6 %)] fueron semilunar tipo I. La edad media fue de 36,7±13,3 (rango: 18-90) años. La distribución por sexos fue la siguiente: 185 (63,1 %) hombres y 108 (36,9 %) mujeres. El semilunar tipo 2 se observó en 207 participantes (41,4 %). La edad media para el tipo 2 fue de 41,6±15,2 (18-88) años. 142 (68,6 %) participantes eran del sexo masculino, mientras que 65 (31,4 %) eran del sexo femenino. La edad media de los sujetos con tipo I mostró una diferencia con el tipo II (p = 0,007). No hubo relación en cuanto al sexo (p=0,206) entre los grupos. En la región de Anatolia, el semilunar tipo 1 era dominante en comparación con el tipo 2. La tasa de incidencia del tipo semilunar en la población de Anatolia fue similar a la de la población árabe.

Scaphoid-capitate-hamate-triquetrum Fusion in the Advanced Kienbock's Disease

PURPOSE: To evaluate clinical and radiological results of SCHT(scapho-capito-hamato-triquetral) fusion in Lichtman stage IIIB or IV Kienbock's disease. MATERIALS AND METHODS: The result of eight cases, operated and followed since December 2002, were analyzed retrospectively. The indication of SCHT fusion was the advanced Kienbock's disease, in Lichtman stage IIIB or IV, with severe fragmentation of lunate. The fragmented lunate was excised and the intercarpal joint between scaphoid and capitate, capitate and hamate, hamate and triquetrum were fused with joint resection, bone graft and multiple K-wires, to make an horse-shoeshaped carpal bone block. The clinical results were evaluated by wrist pain, ROM, any radiologic changes of wrist at last follow-up and Kuschner's method. RESULTS: There were 3 cases of Stage IIIB and 5 cases of stage IV. Mean follow-up period was 28.9 (range 15-53) months, and mean age at the time of operation was 49.4 (range 33~66) years. Two cases were minus ulnar variance, 4 cases were positive and 2 cases were neutral. The wrist range of motion was decreased from 121.8degreesto 90.6degrees(25%). Carpal height ratio was decreased in 1 case. The last follow-up results according to Kuschner's method revealed 4 excellent, 3 good and 1 fair. CONCLUSIONS: SCHT fustion was considered as one of the favorable salvage procedure for the advanced Kienbock's disease. However, biomechanical study using cadaver, long-term follow-up & accumulation of more cases would be needed to confirm its definitive usefulness in the future.

Fratura de stress do gancho do hamato: relato de caso com ênfase aos achados de imagem / Stress fracture of hamate's hook: case report with emphasis to the imaging findings

As fraturas de stress do gancho do hamato estão geralmente associadas com atividades esportivas que utilizam tacos, raquetes e bastões. Devido à ausência de um trauma óbvio, o diagnóstico exige maior conhecimento desta lesão e alto índice de suspeição. Os autores relatam o caso de um jogador de golfe com fratura de stress do gancho do hamato, com diagnóstico e acompanhamento realizados por ressonância magnética e tomografia computadorizada multislice.

Stress fractures of the hook of the hamate are related to sports that use devices such as golf clubs, rackets and baseball bats. Because usually there is no history of obvious trauma, the diagnosis necessitates better knowledge of the lesion and high index of suspicion. The authors report a case of stress fracture of the hook of the hamate in a golf player with diagnosis and follow-updone with magnetic resonance and multislice computer tomography.