| Objective:Hamate bone fractures are relatively rare in clinical practice,but they are more prone to complications,such as fracture nonunion.The purpose of this study is to use Mimics software to reconstruct the morphology and intraosseous blood supply of the hamate bone in three dimensions,to visually analyze the morphological and anatomical characteristics of the hamate bone and its intraosseous blood vessels,and to analyze the causes of nonunion after the hamate bone fracture,and provide an anatomical basis of hamate bone fracture treatment and related operations.Methods:Twelve adult fresh wrist joint specimens were used,including 6 left wrist and 6 right wrist.All specimens were taken X-ray to exclude trauma,bone deformities,surgery,and vascular diseases that affect vascular perfusion.Mix gelatin and red lead oxide in the laboratory,dissolve it in 100ml distilled water at 40℃,and store at 40℃ water.All specimens were thawed at room temperature.The radial and ulnar artery was dissected from the distal end of the specimen,and the radial ulnar artery was intubated and ligated and fixed.The lavage was repeated with heparin sodium,formalin,and heparin sodium until a clear liquid was discharged from the venous stump.Using a constant pressure perfusion device,slowly and uniformly infuse the perfusate from the cannula of the radial ulnar artery.After the perfusion,the specimens were stored in a refrigerator at 4℃ for 24 hours to solidify the contrast agent,and then fixed in 10%formalin for 48 hours.After the specimen is made,the specimen is scanned by Micro-CT,and the data is stored in the Dicom format and stored on the disc for later use.Import CT data,which is Dicom format,into Mimics 20.0 software to establish a three-dimensional model to reconstruct the shape of the hamate bone and the 3D visualization model of the intraosseous blood supply of the hamate bone.Results:The hamate bone has 3 non-articular surfaces.The dorsal and volar surfaces are triangular,and the lateral side of the palm extends laterally to the volar side to form the hook of hamate.Hook is divided into a top,a middle and a base.The distal joint surface of the hamate bone and the base of the 4th and 5th metacarpal bones forms the carpometacarpal joint,the temporal side and the head bone form the joint,and the ulnar side and the triangular bone form the joint.The non-articular surface on the dorsal side is branched into a number of nourishing blood vessels into the bone of the hamate bone by the micro-arterial network,and the hook bone blood supply is supplied in all directions.In the volar side of the non-articular surface of the hamate bone,that is,1-2 root nourishing blood vessels of the basal part of the hook bone hook directly or branch into the bone,and travel to the hamate bone body and the hook respectively.Part of the specimen has a nourishing blood vessel on the ulnar side of the base of the hook of hamate,thereby entering the bone and branching into the the hook of hamate.There are separate small blood vessels at the tip of the hook that enters and branches within the bone.The inner branch of the vascular bone nourished on the side of the hook bone base and the inner branch of the blood vessel bone nourished by the back side of the hook bone and the top of the hook bone,respectively.Conclusions:There are constant nourishing blood vessels in the dorsal and palmar non-articular surface of the hook bone and the top of the hook bone,and they merge with each other in the hook bone.The blood supply in the hook bone and the hook bone is abundant,and it is difficult to provoke ischemic necrosis.The nonunion of the conservative treatment of hamte bone fracture may be due to the type of fracture and the degree of displacement.Clinically,surgical treatment is recommended for fractures with large hamate bone displacement,anatomical reduction reduces the risk of fracture nonunion,and conservative treatment with plaster fixation is recommended for fractures that have no obvious meaning. |
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