A Research Involved In Psychological Reconstruction Of Metacarpophalangeal Joints With Free Grafting Of Metatarsophalangeal Joint Undergo The Osteotomy Under The Cartilage Surface Of Head Of Metatarsal Bone

Objective:to assess the improvement of the flexion function of the metatarsophalangeal joint by the osteotomy under the cartilage surface of head of metatarsal bone as to reconstruct the finger of hand with free grafting.Methods:1.10cases involved2-4metacarpophalangeal joints and metatarsophalangeal joints were sagittal scanned with CT, which were observated in articular surfaces contact range.2. To study the general physiological function,10cadaveric metatarsophalangeal joint and metacarpophalangeal joint were fine dissectted and highly precise replicas were prepared by dental methods, which were observed in the sagittal and coronal plane, meanwhile in radian, curvature, and articular surface, which were mathematical modeled.3. metatarsophalangeal joints were observed in flexion functions also in stability and flexibility after the osteotomy were undergone under the cartilage surface of head of metatarsal bone.16cases of patients,whose metacarpophalangeal joints were replaced or constructed by metatarsophalangeal joints as free grafting, were followed up.X-ray picture, joint function and complication were observed.Results:1.The metatarsophalangeal joint(40%) and metacarpophalangeal joint(30%) were proved to be nonconforming joints. The articular surface of the proximal end of the proximal phalanx have lesser curvatures than the head of metacarpal bone and metatarsal bone. During a flexion/extension movement, the articular surface contacted with each other accounted for two-thirds(60%) of the total radian.2. After the osteotomy had been done,the metatarsophalangeal joint were stable and the angle of flexion movement were increased,we can see the deference between the metatarsophalangeal joint and metacarpophalangeal joint and we need study them deeply.3. The grafted metatarsophalangeal joints were proved to be healthy and in good function, the angle of flexion movement were increased to30°, no apparent changed.Conclusions:The metatarsophalangeal joint and metacarpophalangeal joint were proved to be nonsymmetric joints in physiologic function, psychological reconstruction of metacarpophalangeal joints with free grafting of metatarsophalangeal joint undergo the osteotomy under the cartilage surface of head of metatarsal bone can improve effectively the function of flexion so as to improve the function of the reconstructed finger and joint.