Sesamoid bones of the hand: A multicenter study

The Application of Sesamoid Position in Diagnosing Thumb Metacarpophalangeal Joint Dorsal Dislocation: A Retrospective Study

OBJECTIVES

The position of sesamoid of thumb metacarpophalangeal (MCP) joint changed clearly when the joint was dislocated dorsally. However, the significance of sesamoid location in diagnosing joint dislocation was unclear. The present study aimed to explore the positional relationship between sesamoid bone and thumb metacarpophalangeal joint in normal and dorsal dislocation joints.

METHODS

Between January 2018 and August 2023, we collected 60 isometric plain films from sixty outpatients and reviewed 56 anisometric plain films from twenty-eight emergency patients with dorsal dislocation of thumb MCP joint at Tianjin Hospital, then took measurements on the hand X-ray images. The sesamoid length on its longitudinal axis was defined as DP, the distance between the distal edge of sesamoid and thumb MCP joint was defined as DJ, and the ratio of DJ and DP was R. An independent-samples t-test and paired-samples t-test was utilized to analyze difference among data groups.

RESULTS

The 60 isometric images were from 30 male and 30 female outpatients with normal bone structure in their hands, and the 56 anisometric images of the 28 emergency patients included both preoperative and postoperative materials. Among the outpatients, the actual distance between the distal edge of sesamoid and thumb MCP joint space (DJ) was 2.09 mm and 1.40 mm in males and females, respectively. The authentic average length of sesamoid (DP) was 4.46 mm in males and 4.22 mm in females. The average value of R (the ratio of DJ and DP) in males and females was 0.49 and 0.34, respectively. There were gender-related statistical differences in DJ (p < 0.01) and R (p=0.01), but no statistical difference in DP (p > 0.05). For the 28 emergency patients, the mean value of R was -0.47 before joint reduction and 0.58 after joint reduction, with statistical difference between them (p < 0.01).

CONCLUSIONS

There was significant difference in the relative position between sesamoid and thumb MCP joint when joint dislocation and joint reduction. The distal edge of sesamoid beyond thumb MCP joint could be an evidence in diagnosing joint dorsal dislocation. The distal edge of sesamoid below thumb MCP joint could be an evidence of joint reduction.

The Relationship Between Ossification in Metacarpophalangeal Sesamoids of the Thumb and the Period of Puberty: A Radiographic Study

Objective

The current study aimed to determine the onset of sesamoid bones (Sbs) ossification at the thumb metacarpophalangeal (MCP) joint of the hand and its relationship with puberty.

Methods

This retrospective radiographic study included patients aged 5-17 years. The presence of Sbs was investigated separately for each age group. Patients were classified based on their age, gender, and the presence of radial and ulnar sesamoids.

Results

A total of 1,020 radiographs from 939 patients were analyzed. Sbs began to ossify in girls at the age of 8 years and in boys at the age of 9 years. The ulnar-radial sesamoids were present in all individuals in the same age group at the age of 13-14 years in girls and 15 years in boys. The age at which 50% of the individuals in the same age group had a sesamoid was 10.4 years in girls and 11.9 years in boys on the radial side, 9.5 years in girls, and 11.5 years in boys on the ulnar side.

Conclusions

In all individuals, the time between the onset of sesamoids of the MCP joint and development corresponds to the physiological period of puberty. However, the age at which puberty begins coincides with the time when Sbs begin to ossify in 50% of both sexes in the same age group.

Prevalence of metacarpophalangeal sesamoid bones of the hand in Turkish population

OBJECTIVES

This study aims to investigate the prevalence and location of the metacarpophalangeal (MCP) sesamoid bones using computed tomography (CT) images.

PATIENTS AND METHODS

A total of 767 hands of 735 patients (503 males, 232 females; mean age: 36.9±17.0 years; range, 18 to 105 years) obtained from picture archiving and communication system were retrospectively analyzed between January 2016 and December 2019. The sesamoid bones of MCP joints I, II, III, IV, and V were recorded. Data including age, sex, side, number, pathologies, and location of the sesamoid bones were recorded.

RESULTS

The prevalence of sesamoid bones was found to be 100%, 37.61%, 1.17%, 0.5%, and 80% in MCP I, II, III, IV, and V, respectively. There was no significant correlation between the sex of the patient and presence of sesamoid bone at MCP II or MCP V (p>0.970 and p=0.176, respectively). The presence of sesamoid bone at MCP II was statistically significantly correlated with the presence of sesamoid bone at MCP V (p<0.001). There was no statistically significant difference in the side and sesamoid prevalence in the remaining 703 patients (p>0.05).

CONCLUSION

The prevalence of MCP V sesamoid bone is higher than previous studies from our country. The CT of hand can be used to determine sesamoid fractures and degenerative conditions of sesamoids.

Prevalence and distribution of sesamoid bones of the hand in Omani subjects: a radiological study

Sesamoid bones show considerable variations in their occurrence among various ethnicities. This study aims to evaluate the prevalence and distribution patterns of the sesamoid bones of the hands among Omani patients who were referred for radiological investigations. The influence of gender and different age groups on the occurrence of sesamoid bones of the hand was determined using the Chi-square test. Spearman's rank correlation was used to determine the coexistence of sesamoid bones at the metacarpophalangeal joints. A total of 541 hand radiographs were reviewed. A high prevalence of sesamoid bones at the fifth metacarpophalangeal joint and the interphalangeal joint of the thumb was noted with a frequency of 64% and 49.7%, respectively. There were ten different patterns of sesamoid bones detected, the most common of which was the presence of sesamoid bones at the first and fifth metacarpophalangeal joints found in 32.9% of the radiographs. A statistically significant gender difference was observed at the interphalangeal joint of the thumb (p = 0.025) and fifth metacarpophalangeal joint (p = 0.027) with a female dominance. A significant association between the age and prevalence of sesamoid bones was noted at the fifth metacarpophalangeal joint (p = 0.03). The prevalence of the sesamoid bones of the hand in Omani subjects seems to differ from other Middle Eastern populations, particularly at the fifth metacarpophalangeal joint and the interphalangeal joint of the thumb. In the meantime, the baseline data of our study can be helpful while treating the patients complaining of hand discomfort or pain.