X-ray Morphometric Assessment of the Hand Fingers Palmar Surface Skin Interphalangeal Flexion Grooves to the Interphalangeal Joints Gaps Correspondence

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Co-authors:

Andrey Gal'chin - Aspirant, Morphology and Pathology, Private University REAVIZ

Abstract Body : On the palmar surface of the human hands fingers skin in the area of interphalangeal joints there are grooves that develop in the prenatal period. Their morphogenesis is determined by the corresponding fetal fingers and hands movements. The topography of these flexion grooves along the central finger and phalanges axis does not coincide with the position of the corresponding joints articular gaps and, therefore, cannot serve as their marker for surgical manipulations with them. The purpose of the study was to determine the correspondence of the finger palmar surface flexor skin grooves of the of adults to the position of the interphalangeal joints space. The study was conducted on 140 x-rays of the hand of equally both sexes patients of 18-30 years, standardized according to diagnostic conditions, who came in for hand and wrist joint pain and injuries without any signs of damage of their bone-joints structures. In each case, copper wire with a diameter of 1 mm was placed on the most proximally located interphalangeal grooves of all fingers. Both the position of the corresponding flexion grooves and the position of the joint gap were visualized on the resulting radiographs. The distances between them on radiographs were measured with an electronic caliper with an accuracy of 0.01 mm. It was established that the most proximally located proximal interphalangeal skin grooves of the fingers in 100% of cases were projected within the radiographic shadow of the proximal phalanx on both hands, in both males and females. In women, within the limits of statistical error, exceptions to this pattern were observed in 0.05% of cases. The projection of the distal interphalangeal groove of the fingers in relation to the distal epiphysis of the middle phalanx in 100% of cases was within the radiographic shadow of the middle phalanx, and it was located proximal to the joint space of the distal interphalangeal joint. The distance between the proximal interphalangeal groove and the joint space of the proximal interphalangeal joint ranged from 0 to 9.67 (on the second finger of the left hand) mm for men and from 0 to 8.67 mm for women. The minimum average values of the distance between the joint space of the proximal interphalangeal joint were found in both men and women for the fourth finger of the left hand; they were, respectively, 2.04±0.2 mm and 2.4±0.2 mm (M±m). In women hands the proximal interphalangeal flexion groove in 9.5% of cases on the IV finger and in 3% of cases for the III finger completely coincided with the underlying gap of the proximal interphalangeal joint. The results obtained will facilitate anatomically based surgical manipulations in the distal segment of the hand, which require precise information to maximize the preservation of ranges of motion in the metacarpophalangeal and interphalangeal joints.