Anthropometric characteristics of wrists joint surfaces depending on lunate types.

It is well known that the lunate presents with two main types: lunate type I has one facet of its distal surface only for capitates, whereas lunate type II has two facets of the same surface for capitate and for hamate. Our previous anthropometric studies showed that the lunate type II wrists are of greater size than the lunate type I wrists. The aim of the present study was to determine whether the lunate types and the presence or absence of hamato-lunate joint correlate with anthropometric characteristics of the joint surfaces of other wrists. Sixteen sets of macerated wrists with the lunate type I and 21 with the lunate type II were studied. Two-thousand-four-hundred-and-forty-eight anthropometric measurements were done (for 68 anthropometric indicators) and 864 anthropometric indices were calculated (for 24 anthropometric indices) separately for the wrist joint surfaces. The absolute value of the anthropometric indicators of the joint surfaces of the separated wrists were greater in the wrists with the lunate type II, except for the indicators "Greatest length of the dorsal joint surface of pisiform", "Width of the proximal joint surface, measured in the middle" and "Greatest width of the proximal joint surface" for the trapezoid and "Greatest height of the ulnar joint surface" for the capitate. The enlargement of the joint surfaces for the scaphoid was mainly in proximo-distal direction. The enlargement for the triquetrum and pisiform was mainly in radio-ulnar direction. The enlargement for trapezium, trapezoid and capitate was mainly in dorso-volar direction (except for the ulnar joint surface of capitate). The enlargement for hamate was mainly in radio-ulnar and dorso-volar directions (except for the joint surfaces for capitate and triquetrum). The calculated indices illustrate the quantitative proportions of the variations mentioned above. The anthropometric differences are a good reason to make a clear distinction between both types of wrist joint complexes-with or without a hamato-lunate joint.

Vascular anatomy of the radius and ulna diaphyses in their reconstructive surgery.

The vascular factor in the unsuccessful healing of the osteotomised forearm bone is widely discussed in literature at the so-called "level operations" aiming at correcting the "ulna minus" variant in Kienböck's disease. The purpose of our study was to trace the nourishing vessels of the forearm bones from their source from which a. nutritia radii (ANR) and a. nutritia ulnae (ANU) is separated and to locate the foramen nutritium (FN) of the radial and ulnar bones diaphysis. The forearms of 70 upper extremities were dissected and 204 macerated radial bones and 134 macerated ulnar bones were investigated scopically and metrically. The results demonstrated that there is less variability of sources from which ANR was separated as compared to the variability of the sources from which ANU was separated. Foramen nutritium radii (FNR) and foramen nutritium ulnae (FNU) were located mainly along facies anterior and its edges margo anterior and margo interosseus and only in a few cases they were observed along facies posterior. The metrical investigations showed that FNR were located mainly in the second fourth along the bone length, between 30 and 40% from the radial bone length in the distal direction. FNU were located mainly in the second fourth along the bone length, between 30 and 50% from the ulnar bone length in the distal direction. The results for vascular anatomy of the forearm bones give grounds to assume that osteotomy with a subsequent shortening of the radius is more feasible than osteotomy with ulnar lengthening. The distal half of the radius, between the third and fourth quarter in particular, is also recommended as most suitable for surgical intervention.