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CC BY-NC-ND 4.0 · Indian J Plast Surg 2024; 57(04): 270-277
DOI: 10.1055/s-0044-1787688
Original Article

Indian Hand Anthropometry: Computer Tomography-Based Morphometric Analysis of Metacarpal

Maryada Venkateshwar Reddy 
1   Department of Orthopaedics, KIMS-Sunshine Hospital, Hyderabad, Telangana, India
,
Mithun Pai G. 
2   Department of Hand Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Morum Mahendra Kumar
3   Department of Radiodiagnosis, KIMS-Sunshine Hospital, Hyderabad, Telangana, India
,
Anil K. Bhat
2   Department of Hand Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Adarsh Annapareddy
4   Sunshine Bone and Joint Institute, KIMS-Sunshine Hospital, Hyderabad, Telangana, India
,
Mukund R. Thatte
5   Plastic Surgery Department, Bombay Hospital, Mumbai, Maharashtra, India
6   Plastic Surgery Department, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India
› Author Affiliations Funding None.
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Abstract

Introduction Metacarpal fractures are common and have various treatment options, but understanding their morphometry is crucial for optimizing fixation techniques and reducing complications. Accurate assessment of metacarpal anatomy is challenging in conventional radiographs but feasible with computed tomography (CT) scans, which offer precise views. This study aimed to provide accurate anatomical data on metacarpals within an Indian population using CT scans and to compare the results with existing literature. The findings have implications for surgical procedures, including plating, pinning, and intramedullary screw fixation.

Materials and Methods This retrospective analysis utilized CT scans of 100 hands, including 50 males and 50 females, from two hospitals in India. Inclusion criteria included complete metacarpal visualization with a slice thickness of 0.6 mm, while exclusion criteria involved trauma, deformity, or underlying pathologies. Various parameters of all metacarpals were measured using RadiAnt DICOM Viewer 2021.1, providing accurate anteroposterior and lateral views.

Results Male and female cohorts had mean ages of 38.58 ± 12.02 and 43.60 ± 13.61 years, respectively. The study showed good to excellent reliability in measurements. The 2nd metacarpal was consistently the longest, and the general length pattern was 3rd > 4th > 5th > 1st metacarpal in both genders. Men generally had larger metacarpal dimensions than women, except for intramedullary diameter, which showed minimal sex-related differences. Notably, the medullary cavity's narrowest part was at the 4th metacarpal, and the thumb had the widest intramedullary diameter.

Conclusion This study provides valuable anatomical reference data for metacarpals in an Indian population, aiding in optimizing surgical techniques for metacarpal fractures. The 2nd metacarpal consistently stood out as the longest, and men generally had larger metacarpal dimensions than women. These insights into anatomical variations can inform clinical decisions and stimulate further research in this field. However, a larger and more diverse sample would enhance the study's representativeness.

Keywords

metacarpals - metacarpal fractures - CT scans - Indian population - morphometry - normative data

Ethical Approval

Approval Letter Number: SIEC/2021/456.


SIEC Meeting Number: SIEC/2021/52.


Authors' Contributions

M.V.R. served as the principal investigator and was responsible for data collection, measurement, analysis, and manuscript writing. M.P.G. contributed to data collection, analysis, and manuscript writing. M.M.K. handled measurements, statistical analysis, and manuscript editing. A.K.B. was involved in data collection, statistical analysis, and manuscript editing. A.A. was responsible for data retrieval, literature search, and manuscript writing. M.R.T. contributed to the concept, analysis, and manuscript editing.




Publication History

Article published online:
12 June 2024

© 2024. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Chung KC, Spilson SV. The frequency and epidemiology of hand and forearm fractures in the United States. J Hand Surg Am 2001; 26 (05) 908-915
    CrossrefPubMedGoogle Scholar
  • 2 Hazan J, Azzi AJ, Thibaudeau S. Surgical fixation of metacarpal shaft fractures using absorbable implants: a systematic review of the literature. Hand (N Y) 2019; 14 (01) 19-26
    CrossrefPubMedGoogle Scholar
  • 3 Nakashian MN, Pointer L, Owens BD, Wolf JM. Incidence of metacarpal fractures in the US population. Hand (N Y) 2012; 7 (04) 426-430
    CrossrefPubMedGoogle Scholar
  • 4 Lamraski G, Monsaert A, De Maeseneer M, Haentjens P. Reliability and validity of plain radiographs to assess angulation of small finger metacarpal neck fractures: human cadaveric study. J Orthop Res 2006; 24 (01) 37-45
    CrossrefPubMedGoogle Scholar
  • 5 Tolentino ES, Yamashita FC, de Albuquerque S. et al. Reliability and accuracy of linear measurements in cone-beam computed tomography using different software programs and voxel sizes. J Conserv Dent 2018; 21 (06) 607-612
    CrossrefPubMedGoogle Scholar
  • 6 Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 2016; 15 (02) 155-163
    CrossrefPubMedGoogle Scholar
  • 7 El Morsi DA, Al Hawary AA. Sex determination by the length of metacarpals and phalanges: X-ray study on Egyptian population. J Forensic Leg Med 2013; 20 (01) 6-13
    CrossrefPubMedGoogle Scholar
  • 8 Okoli M, Lutsky K, Rivlin M, Katt B, Beredjiklian P. Metacarpal bony dimensions related to headless compression screw sizes. J Hand Microsurg 2020; 12 (Suppl. 01) S39-S44
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Örs A, Çolak T, Bamaç B. et al. Morphometric evaluation of second to fifth metacarpals for retrograde intramedullary headless screw fixation. Int J Morphol 2022; 40 (04) 1075-1080
    CrossrefGoogle Scholar
  • 10 Sephien A, Bethel CF, Gulick D, Nairn C, Ourn F, Schwartz-Fernandes FA. Inter-relationships of metacarpals 1 to 5, regarding their length, metaphyseal midshaft width, articular surface area of head and base, age, and sex: a cadaveric study. Hand (N Y) 2021; 16 (05) 706-713
    CrossrefPubMedGoogle Scholar
  • 11 Martin R. Textbook of Anthropology in Systematic Presentation: With Special Consideration of Anthropological Methods; For Students, Doctors, and Explorers. Jena: Gustav Fischer; 1914. DOI: 10.11588/diglit.37612#0001
    CrossrefGoogle Scholar
  • 12 Scheuer JL, Elkington NM. Sex determination from metacarpals and the first proximal phalanx. J Forensic Sci 1993; 38 (04) 769-778
    CrossrefPubMedGoogle Scholar
  • 13 Case DT, Rawlins CM, Mick CB. Measurement standards for human metacarpals. Am J Phys Anthropol 2015; 157 (02) 322-329
    CrossrefPubMedGoogle Scholar
  • 14 Deschênes VA. Asymmetry of Hands-On Modern Human: A Geometric Morphometric Analysis of Metacarpal Bones. Archéol Prehistory. 2017. [Dumas ID: dumas-01723522]
    Google Scholar
  • 15 Lazar G, Schulter-Ellis FP. Intramedullary structure of human metacarpals. J Hand Surg Am 1980; 5 (05) 477-481
    CrossrefPubMedGoogle Scholar
  • 16 Dunleavy ML, Candela X, Darowish M. Morphological analysis of metacarpal shafts with respect to retrograde intramedullary headless screw fixation. Hand (N Y) 2022; 17 (04) 602-608
    CrossrefPubMedGoogle Scholar
  • 17 Hoang D, Vu CL, Jackson M, Huang JI. An anatomical study of metacarpal morphology utilizing CT scans: evaluating parameters for antegrade intramedullary compression screw fixation of metacarpal fractures. J Hand Surg Am 2021; 46 (02) 149.e1-149.e8
    CrossrefPubMedGoogle Scholar
  • 18 ten Berg PW, Mudgal CS, Leibman MI, Belsky MR, Ruchelsman DE. Quantitative 3-dimensional CT analyses of intramedullary headless screw fixation for metacarpal neck fractures. J Hand Surg Am 2013; 38 (02) 322-330.e2
    CrossrefPubMedGoogle Scholar