Diğer metakarp cisim, baş ve taban kırıkları BT bulguları

Özet

Metakarp cisim kırıkları transvers, oblik (spiral dahil) veya parçalı patern gösterebilir. Rotasyonel dizilim bozukluğu parmaklarda örtüşmeye yol açarak kavrama ve manipülasyonu etkileyebilir. BT, metakarp başı veya tabanındaki eklem içi kırıkların paternini ve eklem tutulumunu değerlendirmeye yardımcı olur. Proksimal metakarpların grafide üst üste binmesi CMC hizasını değerlendirmeyi güçleştirebilir.

Faz ve pencere

Kontrastsız tanısal: BT, kırık paternini belirlemeye ve tanıyı doğrulamaya yardımcı olabilir.
Kemik algoritması tanısal: Çok düzlemli BT, kırık paternini ve eklem yüzü tutulumunu farklı düzlemlerde değerlendirmeye yardımcı olur.

Önerilen pencereler: Kemik (G 1800 / M 400).

BT bulguları

Transvers cisim kırığı — metakarp cisim kırıkları transvers patern gösterebilir.
Oblik veya spiral cisim kırığı — oblik patern spiral kırıkları da kapsar.
Parçalı cisim kırığı — metakarp cisim kırıkları parçalı patern gösterebilir.
Metakarp başı kırığı — baş kırıkları eklem içi olabilir; MCP eklem uyumu kavrama ve manipülasyon işlevi açısından önemlidir.
CMC hizalanma kaybı — dördüncü ve beşinci metakarp taban yaralanmalarında hamat kemiği patolojisi sıklıkla eşlik eder; bu yapıların ilişkisi değerlendirilmelidir.
Çoklu metakarp yaralanması — kırıklar birden fazla metakarpı veya başka kemikleri birlikte tutabilir.

Normalde

Dördüncü ve beşinci metakarp tabanları ile hamat kemiği fonksiyonel olarak ilişkilidir; hamat patolojileri sıklıkla bu CMC eklemi instabilitesi ile birlikte görülür.

Ayırıcı tanı

Metakarp başı osteonekrozu: subkondral skleroz/çökme yapabilir; akut travmatik ayrışmış fragman ve kortikal kırık hattı bulunmayabilir.
CMC çıkığı: eklem yüzleri yer değiştirmiştir ancak metakarp tabanında kırık fragmanı saptanmayabilir.
Osteokondral serbest cisim: MCP ekleminde osteoartrit sonrası eklem içi serbest cisim görülebilir.

Tuzaklar

BT, dördüncü ve beşinci metakarp tabanı kırıkları ve hamat yaralanmalarıyla sık eşlik eden CMC eklemi instabilitesinin ve eklem uyumsuzluğunun değerlendirilmesinde yardımcı olur.
Rotasyonel bozukluk radyografilerde minimal kayma gibi görünebilir; fleksiyon sırasında parmak uçlarının skafide yönlendiği klinik muayene ile doğrulanmalıdır.

Kendini dene

Metakarp başında MCP eklem yüzüne uzanan ve eklem uyumunu bozan kırık görülüyor. En doğru tanım hangisidir?
Cevabı göster
Eklem içi metakarp başı kırığı. Metakarp başı kırıkları eklem içi olabilir ve eklem uyumu MCP işlevi için önemlidir. Cisim, taban ve boyun ayrı anatomik kırık yerleşimleridir.
Dördüncü ve beşinci metakarp tabanlarının grafide üst üste binmesi CMC hizasını belirsiz kılıyor. Bu tabanlarla doğrudan eklemleşen karpal kemik hangisidir?
Cevabı göster
Hamat. Hamat distalden dördüncü ve beşinci metakarp tabanlarıyla eklemleşir; diğer seçenekler bu iki CMC ekleminin karşılıklı yüzü değildir.

İlgili konular

5. metakarp tabanı kırıklı çıkığı (ters Bennett)

Kaynaklar

Bu sayfadaki 30 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla tek tek karşılaştırıldı; 28 cümle bu karşılaştırmada düzeltildi (2026-10-08).

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