{"title":"中趾骨的侧中线纵沟:解剖学研究与临床意义。","authors":"","doi":"10.1016/j.jhsa.2022.10.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p><span>To investigate the volar anatomy of the </span>middle phalanges of the hand; in particular, to define the presence and depth of a volar midline longitudinal groove.</p></div><div><h3>Methods</h3><p>Measurements were performed at 5 equidistant points along the shafts of 60 skeletonized middle phalanges from 15 cadaveric hands. The thickness at the midline of each phalanx was subtracted from the maximal dorsovolar thickness to indicate the presence or absence of a groove at each point. The phalanges were also evaluated by computed tomography to confirm the presence of a volar groove and to rule out morphological abnormalities.</p></div><div><h3>Results</h3><p>A volar groove was confirmed in all 60 phalanges. The groove had an average depth of 0.4 mm and was found to be deepest at the mid-phalangeal shaft. The groove reached a depth of greater than 1 mm in 23% of the phalanges. The middle phalanges of the middle and ring digits consistently revealed deeper grooves than those found in the index and little fingers. Computed tomography confirmed the presence of a volar groove and showed no morphological abnormalities.</p></div><div><h3>Conclusions</h3><p>A midline volar longitudinal groove is present in the middle phalanges, is most pronounced in the mid-phalangeal shaft, and is the deepest in the middle and ring fingers.</p></div><div><h3>Clinical relevance</h3><p>Surgeons should be cognizant of the volar longitudinal groove when inserting screws from dorsal to volar during the fixation of middle phalangeal fractures<span>. Lateral intraoperative fluoroscopy may not reveal excessive screw penetration because of the presence of ridges on either side of the groove. Particular care should be taken at the mid-phalangeal level of the middle phalanges of the middle and ring fingers.</span></p></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Volar Midline Longitudinal Groove of the Middle Phalanx: An Anatomic Study and Clinical Implications\",\"authors\":\"\",\"doi\":\"10.1016/j.jhsa.2022.10.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p><span>To investigate the volar anatomy of the </span>middle phalanges of the hand; in particular, to define the presence and depth of a volar midline longitudinal groove.</p></div><div><h3>Methods</h3><p>Measurements were performed at 5 equidistant points along the shafts of 60 skeletonized middle phalanges from 15 cadaveric hands. The thickness at the midline of each phalanx was subtracted from the maximal dorsovolar thickness to indicate the presence or absence of a groove at each point. The phalanges were also evaluated by computed tomography to confirm the presence of a volar groove and to rule out morphological abnormalities.</p></div><div><h3>Results</h3><p>A volar groove was confirmed in all 60 phalanges. The groove had an average depth of 0.4 mm and was found to be deepest at the mid-phalangeal shaft. The groove reached a depth of greater than 1 mm in 23% of the phalanges. The middle phalanges of the middle and ring digits consistently revealed deeper grooves than those found in the index and little fingers. Computed tomography confirmed the presence of a volar groove and showed no morphological abnormalities.</p></div><div><h3>Conclusions</h3><p>A midline volar longitudinal groove is present in the middle phalanges, is most pronounced in the mid-phalangeal shaft, and is the deepest in the middle and ring fingers.</p></div><div><h3>Clinical relevance</h3><p>Surgeons should be cognizant of the volar longitudinal groove when inserting screws from dorsal to volar during the fixation of middle phalangeal fractures<span>. Lateral intraoperative fluoroscopy may not reveal excessive screw penetration because of the presence of ridges on either side of the groove. Particular care should be taken at the mid-phalangeal level of the middle phalanges of the middle and ring fingers.</span></p></div>\",\"PeriodicalId\":54815,\"journal\":{\"name\":\"Journal of Hand Surgery-American Volume\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hand Surgery-American Volume\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0363502322006049\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hand Surgery-American Volume","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0363502322006049","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
The Volar Midline Longitudinal Groove of the Middle Phalanx: An Anatomic Study and Clinical Implications
Purpose
To investigate the volar anatomy of the middle phalanges of the hand; in particular, to define the presence and depth of a volar midline longitudinal groove.
Methods
Measurements were performed at 5 equidistant points along the shafts of 60 skeletonized middle phalanges from 15 cadaveric hands. The thickness at the midline of each phalanx was subtracted from the maximal dorsovolar thickness to indicate the presence or absence of a groove at each point. The phalanges were also evaluated by computed tomography to confirm the presence of a volar groove and to rule out morphological abnormalities.
Results
A volar groove was confirmed in all 60 phalanges. The groove had an average depth of 0.4 mm and was found to be deepest at the mid-phalangeal shaft. The groove reached a depth of greater than 1 mm in 23% of the phalanges. The middle phalanges of the middle and ring digits consistently revealed deeper grooves than those found in the index and little fingers. Computed tomography confirmed the presence of a volar groove and showed no morphological abnormalities.
Conclusions
A midline volar longitudinal groove is present in the middle phalanges, is most pronounced in the mid-phalangeal shaft, and is the deepest in the middle and ring fingers.
Clinical relevance
Surgeons should be cognizant of the volar longitudinal groove when inserting screws from dorsal to volar during the fixation of middle phalangeal fractures. Lateral intraoperative fluoroscopy may not reveal excessive screw penetration because of the presence of ridges on either side of the groove. Particular care should be taken at the mid-phalangeal level of the middle phalanges of the middle and ring fingers.
期刊介绍:
The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.