The hand consists of five sesamoids. Two of them are present at the metacarpophalangeal （MCP）joint of the thumb. Fracture of the sesamoid bones of the thumb is a rare injury and the literature on the radial side is ...The hand consists of five sesamoids. Two of them are present at the metacarpophalangeal （MCP）joint of the thumb. Fracture of the sesamoid bones of the thumb is a rare injury and the literature on the radial side is seldom reported. We reported a case of a patient with a fracture of the radial sesamoid at the MCP joint of the thumb in order to increase attention regarding this type of injuries. A 44-year-old male, high level gymnastic trainer, was helping one of his athletes during an exercise while he reported a hyperextension trauma to the MCP joint of the right thumb.One week after trauma, he presented to the hand surgeon complaining of a painful thumb at the MCP joint level on its palmar aspect. Standard A-P and lateral X-rays revealed a fracture of the radial sesamoid and the fracture was treated with a splint for 3 weeks. He was able to resumed his entire work 6 weeks after the injury. The sesamoid fractures is an indicator of the magnitude of the hyperextension injury and sometimes associated with tears of the volar plate ligament of the MCP joint. And a failure to recognize the ligament injury may lead to a long-term hyperextension instability on pinching.展开更多
Background A causal link between the metatarsus adductus and hallux valgus is not clear.The aim of this study was to investigate the configurations of the metatarsus adductus deformity by radiological measurements and...Background A causal link between the metatarsus adductus and hallux valgus is not clear.The aim of this study was to investigate the configurations of the metatarsus adductus deformity by radiological measurements and reappraise the relationship between hallux valgus and metatarsus adductus.Methods The first step was evaluation of the relationship between metatarsus adductus and hallux valgus on 143 dorsoplantar weight-bearing radiographs diagnosed as hallux valgus which was also known as bunions.Measurements including the hallux valgus angle （HVA）,the intermetatarsal angle （IMA）,the Kilmartin angle （KA）,the tibial sesamoid position （TSP）,and metatarsus adductus angle were taken.The metatarsus adductus angle is defined by Sgarlato＇s angle （SMA） and Engel＇s angle （EMA） respectively.Results The metatarsus adductus angle positively correlates with the HVA （r=0.590,P=0.000） and KA （r=0.601,P=0.000）,yet negatively correlates with the grade of TSP,（r=-0.348,P=0.000）.Contradiction of diagnosis existed in 22 （22/100） subjects diagnosed as metatarsus adductus by SMA yet normal by EMA.In this group,the correlation between HVA and metatarsus adductus angle was negative （r=-0.472,P=0.027）.Conclusions EMA and SMA defined metatarsus adductus by different deformity apexes.Metatarsus adductus configurations in that the apex of the deformity lay in either the base of metatarsals or tarsus.They respectively correlate positively or negatively to the HVA.展开更多
文摘The hand consists of five sesamoids. Two of them are present at the metacarpophalangeal （MCP）joint of the thumb. Fracture of the sesamoid bones of the thumb is a rare injury and the literature on the radial side is seldom reported. We reported a case of a patient with a fracture of the radial sesamoid at the MCP joint of the thumb in order to increase attention regarding this type of injuries. A 44-year-old male, high level gymnastic trainer, was helping one of his athletes during an exercise while he reported a hyperextension trauma to the MCP joint of the right thumb.One week after trauma, he presented to the hand surgeon complaining of a painful thumb at the MCP joint level on its palmar aspect. Standard A-P and lateral X-rays revealed a fracture of the radial sesamoid and the fracture was treated with a splint for 3 weeks. He was able to resumed his entire work 6 weeks after the injury. The sesamoid fractures is an indicator of the magnitude of the hyperextension injury and sometimes associated with tears of the volar plate ligament of the MCP joint. And a failure to recognize the ligament injury may lead to a long-term hyperextension instability on pinching.
基金This work was supported by a grant from the National Natural Science Foundation of China （No.81171670/H0601）.
文摘Background A causal link between the metatarsus adductus and hallux valgus is not clear.The aim of this study was to investigate the configurations of the metatarsus adductus deformity by radiological measurements and reappraise the relationship between hallux valgus and metatarsus adductus.Methods The first step was evaluation of the relationship between metatarsus adductus and hallux valgus on 143 dorsoplantar weight-bearing radiographs diagnosed as hallux valgus which was also known as bunions.Measurements including the hallux valgus angle （HVA）,the intermetatarsal angle （IMA）,the Kilmartin angle （KA）,the tibial sesamoid position （TSP）,and metatarsus adductus angle were taken.The metatarsus adductus angle is defined by Sgarlato＇s angle （SMA） and Engel＇s angle （EMA） respectively.Results The metatarsus adductus angle positively correlates with the HVA （r=0.590,P=0.000） and KA （r=0.601,P=0.000）,yet negatively correlates with the grade of TSP,（r=-0.348,P=0.000）.Contradiction of diagnosis existed in 22 （22/100） subjects diagnosed as metatarsus adductus by SMA yet normal by EMA.In this group,the correlation between HVA and metatarsus adductus angle was negative （r=-0.472,P=0.027）.Conclusions EMA and SMA defined metatarsus adductus by different deformity apexes.Metatarsus adductus configurations in that the apex of the deformity lay in either the base of metatarsals or tarsus.They respectively correlate positively or negatively to the HVA.
