6533b828fe1ef96bd12886b1

RESEARCH PRODUCT

Chondrocostal grafting for lateral osteochondral injury of the metacarpal head

Javier Zurriaga-cardaAntonio Silvestre-muñozRaul Rojas-díazLuis Puertes-almenar

subject

medicine.medical_specialtyIntra-Articular Fracturesmedicine.medical_treatmentGrafting (decision trees)OsteoarthritisBone grafting03 medical and health sciences0302 clinical medicineHumansMedicineOrthopedics and Sports MedicineRange of Motion ArticularFractures Comminuted030222 orthopedicsBone Transplantationmedicine.diagnostic_testbusiness.industryCartilageMagnetic resonance imaging030229 sport sciencesMetacarpal Bonesmedicine.diseaseSurgerymedicine.anatomical_structureHead (vessel)SurgeryCortical bonebusinessRange of motion

description

Abstract Osteochondral injuries of the metacarpal head require anatomical restoration to prevent limitations in range of motion and osteoarthritis. Osteochondral bone grafting is a viable option, especially in younger patients. Central injuries allow for different types of grafting, but when the injured area is on the lateral portion of the metacarpal head, the graft must include both a cortical and a cartilaginous portion. We present here the pearls and pitfalls in the surgical technique of chondrocostal grating from the 6th rib and an example of its use within a case of comminuted fracture of the metacarpal head. This technique provides a graft with cortical bone that allows for a stable fixation, with few complications during its harvesting. The graft is viable in the long-term and shows similar magnetic resonance intensities in comparison to hand cartilage.

https://doi.org/10.1016/j.otsr.2019.12.006