A turret exostosis was known a smooth, dome-shaped extracortical collection of subperiosteal bone beneath the extensor apparatus. In most cases, turret exostosis involve middle and distal phalanges compared with involving metacarpal cases have been rarely reported in the literature.
Exostoses ; Metacarpus

Avascular necrosis of the metacarpal head named as 'Dieterich disease' is a very rare condition. Because of the lack of information about the natural course and treatment of this disease, the ideal treatment has not been established as yet. We report a case of avascular necrosis that occurred at the 3rd metacarpal head after fractures of the 4th and 5th metacarpal base; this was treated conservatively and obtained the spontaneous resolution.
Head ; Metacarpal Bones ; Metacarpus ; Necrosis ; Osteonecrosis

This study proposed an assessment of the correlation of hand bone mineral density measured by dual energy x-ray absorbtiometry (DXA) with the carpo:metacarpal (C:MC) ratio and metacarpal cortical index (CI) in patients with rheumatoid arthritis (RA). The correlation of total hand BMD, CI and C:MC ratio with BMD at other sites, the Health Assessment Questionnaire (HAQ) and Larsen scores were also examined. The hand and axial BMD of 30 female patients were also compared with 29 age-matched healthy female controls. Total hand BMD values of patients were significantly lower than the control group. There was no significant difference between groups in axial measurements. CI correlated moderately with the second metacap (II.MC) midshaft and total hand BMD. The C:MC ratio correlated with II.MC midshaft and total hand BMD. Total hand BMD correlated moderately with the AP spine (L2-L4) and femoral neck BMD. Larsen scores showed weak negative correlation with II.MC midshaft BMD and CI. Grip strength correlated weakly only with total hand BMD. The results indicated that CI may reflect cortical bone mass of the hand accurately and did not predict bone density of the spine or hip in patients with RA. The C:MC ratio is a useful method for evaluating progression of wrist involvement and may be related to the loss of hand bone mineral density associated with disease process.
Adult ; Aged ; Arthritis, Rheumatoid/metabolism* ; Bone Density* ; Female ; Hand* ; Human ; Metacarpus/metabolism* ; Middle Age

Adolescent ; Adult ; Female ; Fracture Fixation ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Metacarpus ; injuries ; Middle Aged

OBJECTIVES: To study the injury manners of Bennett fracture and Rolando fracture and explore its identification principle of the first metacarpal base fractures. METHODS: Totally 31 cases of Bennett fracture and Rolando fracture were collected. The injury manners of cases of 19 Bennett fractures and 12 Rolando fracture were classified, and various injury manners were analysed statistically. RESULTS: The injury manners of the cases of 19 Bennett fracture and 12 Rolando fracture were divided into three types, including the first metacarpus hit hard objects during a punching, the first metacarpus hit hard objects when making fists and fell, or the first metacarpus was punched by hard objects when making fists. CONCLUSIONS The injury mechanism of Bennett fracture and Rolando fracture is formed by a force on the first metacarpus when making fists, which transmits to the basilar part along the vertical axis of metacarpus. The inference of injury manners should be focused on the confirmation of entrusted matters.
Epiphyses ; Fracture Fixation, Internal/methods* ; Fractures, Bone/surgery* ; Humans ; Joint Dislocations/surgery* ; Metacarpus/injuries* ; Thumb/injuries*

PURPOSES: Radiologic findings of hands in Turner syndrome(TS) which have been reported were metacarpal sign(MS), carpal sign(CS), phalangeal sign(PS), osteopenia, and delayed bone maturation. The aim of this study is to evaluate the difference of radiologic findings in TS, idiopathic short stature(ISS), and growth hormone deficiency(GHD). METHODS: Sixty girls with short stature were studied for chromosome analysis, and growth hormone provocation test. Simple radiography of hands was also used in this study. They were divided into three groups; 25 cases of TS(45, XO, 13 cases; variants, 12 cases), 24 cases of ISS, and 11 cases of GHD. MS was the distance between the line drawn tangential to the heads of the fourth and fifth metacarpal bones and the distal end of the third metacarpal head. CS was the angle between the line tangential to scaphoid and lunate and the line tangential to lunate and triquetrum. PS was the difference between the sum of the length of distal and proximal phalanges of the fourth finger and the length of the fourth metacarpus. Frequency of osteopenia and the shortening of the fifth middle phalanx among three groups were compared. RESULTS: MS was 0.06+/-4.66 mm in TS, -1.96+/-1.83 mm in ISS, and -2.63+/-30 mm in GHD. CS was 116.54+/-11.52degreein TS, 129.42+/-5.52degreein ISS, and 125.54+/-7.22degreein GHD. PS was 0.52+/-0.34 mm in TS, 0.38+/-0.20 mm in ISS, and 0.33+/-0.20 mm in GHD. There were statistically significant differences between TS and ISS, between TS and GHD, respectively in MS, CS, and PS(P<0.05). There were no significant differences in MS, CS, and PS between 45, XO and variants of TS. Osteopenia was observed in 92.3% of TS, and 54.2% of ISS, and 81.8% of GHD. Shortening of the fifth middle phalanx was observed in 56.0% of TS, 25.0% of ISS, and 45.5% of GHD. CONCLUSION: Simple radiologic findings of hands are helpful in differential diagnosis of TS and other short stature children.
Bone Diseases, Metabolic ; Child ; Diagnosis, Differential ; Female ; Fingers ; Growth Hormone ; Hand* ; Head ; Humans ; Metacarpal Bones ; Metacarpus ; Radiography ; Turner Syndrome*

Bone Diseases, Developmental ; diagnosis ; surgery ; Female ; Humans ; Metacarpal Bones ; diagnostic imaging ; surgery ; Metacarpus ; diagnostic imaging ; surgery ; Middle Aged ; Radiography

OBJECTIVETo investigate the treatment of the displaced neck and subcapital fractures of the fifth metacarpal.

METHODSThirty-one patients with the neck and subcapital fractures of the fifth metacarpal had been operated on with antegrade intramedullary fixation between January and August 2005. There was 11 subcapital fractures (group A), and 20 neck fractures (group B). Following closed reduction of the fracture, a blunt 2.0 mm diameter K-wire, which was pre-bent into 20 degrees at the distal end, was inserted into the medullary canal of the fifth metacarpal and fixed the fractures. Postoperatively, patients in group A were immobilized in a short arm plaster splint for 4 weeks, and the ones in group B were treated with unrestricted mobilization.

RESULTSOperative time was 18 min averagely (range 5 to 30 min). Twenty-nine of 31 patients obtained anatomic reduction, and 2 patients had 2/3 apposition of bone end and no rotational deformity. Follow-up was available for all patients. The average follow-up interval was 4 months, with a range of 3 - 6 months. The head/shaft angle of the fifth metacarpal in group A was 63.4 degrees +/- 14.5 degrees preoperatively, and 15.0 degrees +/- 2.5 degrees postoperatively, and 15.4 degrees +/- 2.6 degrees in 3 months postoperatively. The difference between preoperative and postoperative angles was highly significant. The range of motion of the metacarpal joint was 89.5 degrees +/- 4.3 degrees postoperatively, which was not significantly different compared with that of uninjured side. The head/shaft angle in group B was 59.1 degrees +/- 10.0 degrees preoperatively, and 15.9 degrees +/- 2.5 degrees postoperatively, and 15.5 degrees +/- 2.8 degrees in 3 months postoperatively. The difference between preoperative and postoperative angles was highly significant. The range of motion of the metacarpal joint was 88.6 degrees +/- 3.6 degrees postoperatively, which was not significantly different compared with that of uninjured side.

CONCLUSIONSThe technique is technically easy to perform, minimally invasive, low-cost, allowing early hand mobilization, with good functional results and low morbidity, and it has been proved to be an ideal method.

Adolescent ; Adult ; Follow-Up Studies ; Fracture Fixation, Intramedullary ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Metacarpus ; injuries ; Treatment Outcome

OBJECTIVETo observe the clinical effects of miniaturized metacarpus steel plate for the treatment of child epiphysis injury, and to analyse its clinical advantages in the child epiphysis injury.

METHODSFrom June 2004 to May 2009, 85 children with epiphysis injury treated with miniaturized metacarpus steel plate included 52 boys and 33 girls with an average age of 6.6 years old ranging from 1 to 14 years. All the children suffered from just one part injury. There were 68 cases of upper limb injury, 19 of which were humerus epicondyle injury, 16 humerus head injury, 12 olecranon injury, 14 distal radius injury and 7 head of radius injury. The other 17 cases were lower limb injury, 12 of which were femur epicondyle injury and 5 tibia epicondyle injury.

RESULTSAll children obtained good intention,and no postoperative complications occurrenced. Eighty-one children were followed up for 6 months to 5 years (averaged 2.6 years). The results were evaluated at 4 weeks after the operation and showed that there were excellent in 44 cases, good in 21 cases, fair in 11 cases and poor in 9 cases.

CONCLUSIONTreatment of child epiphysis injury with miniaturized metacarpus steel plate can achieve perfect anatomical reduction in the early stage, protect the biological environment of the recovery. This treatment makes the postoperative joint functions and movements recovery nice, barely cause any bone malformation, and worth further clinical applications.

Adolescent ; Bone Plates ; Child ; Child, Preschool ; Epiphyses ; diagnostic imaging ; injuries ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Metacarpus ; Miniaturization ; methods ; Steel ; Tomography, X-Ray Computed ; Treatment Outcome

BACKGROUNDColles' fracture usually associated with osteoporosis is regarded as the predictor of subsequent osteoporotic fracture. However, it is not clear how the local changes of bone mass take place during the course of treatment and whether the changes are related to clinical practice. The objective of the current study was to investigate the local changes of bone mass in patients with Colles' fracture and their possible clinical relevance in a follow-up study.

METHODSThe radiograms of the second metacarpal in 64 patients with Colles' fracture were assessed for bone density immediately after fracture, 6 weeks, 6 months and 1 year after fracture, respectively. Functional results were evaluated at one year.

RESULTSBone mass six weeks after Colles' fracture was significantly decreased without returning to normal at one year though increased bone mass had been identified 6 months after fracture (P < 0.05), (P < 0.01). At one year significant (P < 0.05) or highly significant (P < 0.01) correlations were observed between bone mass indices of metacarpal and functional results, indicating that poor function is associated with lower bone density. Significant differences (P < 0.05) between fracture patterns also suggested that patients with more severe fractures have a more pronounced bone loss.

CONCLUSIONSBone loss during the course of treatment will have a direct effect upon the prognosis, so different treatment should be proposed for different patterns of fractures. Active exercise should be made to improve the recovery of bone mass.

Adult ; Aged ; Bone Density ; Colles' Fracture ; complications ; diagnostic imaging ; Female ; Follow-Up Studies ; Humans ; Male ; Metacarpus ; diagnostic imaging ; Middle Aged ; Osteoporosis ; etiology ; Radiography