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Reconstruction of the distal radius facet by a free vascularized osteochondral autograft: anatomic study and report of a patient |
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| Authors: | Del Piñal Francisco García-Bernal Francisco J Delgado Julio Sanmartín Marcos Regalado Javier |
| Affiliation: | 1. Instituto de Traumatología Cordobés, Córdoba, Spain;2. Department of Orthopedic Surgery, Hospital Universitario Reina Sofía, Córdoba, Spain;1. Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute-Emory University, Atlanta, GA;2. Department of Urology, Winship Cancer Institute-Emory University, Atlanta, GA;1. Department of Cardiovascular Surgery, Medicana International Hospital, Istanbul, Turkey;2. Department of Cardiovascular Surgery, Medipol University, Istanbul, Turkey;1. Service de chirurgie plastique et reconstructrice de l’appareil locomoteur, centre chirurgical Émile-Gallé, 49, rue Hermite, 54000 Nancy, France;2. Service de chirurgie de la main, hôpital Kirchberg, 9, rue Edward-Steichen, 2540 Luxembourg Kirchberg, Luxembourg;1. Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD, USA;2. Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA;3. Division of Plastic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA |
| Abstract: | PURPOSE: Large chondral defects of the distal radius after fractures present a reconstructive challenge. The purpose of this study was to present the anatomic findings from a cadaver of a vascularized osteochondral autograft taken from the third metatarsal appropriate for reconstructing the distal radius articular facet. A patient is presented in whom 70% of the scaphoid fossa was reconstructed with this technique. METHODS: The base of the third metatarsal was studied in the feet of 20 cadavers. The size and shape of the cartilage were measured. Additionally vessel distribution was recorded and the diameters of vascular foramina were measured with Juch's method. RESULTS: The base of the third metatarsal is pear shaped and is wider dorsally than plantarly. It averages 19.2 mm long on its main axis. Its cartilaginous surface is minimally concave or flat and it is slanted slightly proximal-dorsal to distal-plantar and proximal-peroneal to distal-tibial. Nutrient foramina were found in every case in the dorsum and on both sides of the proximal shaft. At least 1 nutrient vessel could be tracked back to the dorsalis pedis in every dissected specimen. CONCLUSIONS: The anatomic features of the base of the third metatarsal make it a potential vascularized autograft to consider for osteochondral defects of the distal radius. |
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