{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:49:46Z","timestamp":1740167386887,"version":"3.37.3"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Wrist Surg"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Fifth carpometacarpal joint (CMCJ) fracture dislocation is a relatively rare injury and most will require operative treatment because of its unstable nature. Improper reduction and fixation lead to joint surface destruction, pain, and reduced grasping power. Intra-articular fragment reduction is often obscured by dorsally displaced ulnar fragment. Therefore, fifth CMCJ arthroscopy can be advantageous in assisting intra-articular fragment reduction. However, there is no detailed description of the portal landmarks or portals' relationship with adjacent important structures in the literature.<\/jats:p><jats:p>\n          Purposes\u2003To explore the feasibility and safety of fifth CMCJ arthroscopy, locations of the portals are examined in cadaveric hand specimens. Their proximity to important anatomical structures such as dorsal cutaneous branch of ulnar nerve (DCBUN), ring finger and little finger extensor digitorum communis (EDC), and extensor digiti minimi (EDM) is measured.<\/jats:p><jats:p>\n          Methods\u2003Fifth CMCJ arthroscopy is performed on 11 cadaveric hand specimens by specialist-level surgeon. The portals are marked and portal positions are further confirmed under the fluoroscopy. Then the cadaveric specimens were undergone anatomical dissection by specialist-level surgeon. During dissection, the spatial relationship between the portal positions and DCBUN, EDC to ring finger and little finger, and EDM is identified. The distance between the portals and the above important structures was measured in millimeters.<\/jats:p><jats:p>\n          Results\u2003DCBUN was consistently found between fourth metacarpohamate (4-MH) and fifth metacarpohamate (5-MH) portals, with it being closer to the latter (mean distance, 2.03\u2009mm; range, 0\u20134.43\u2009mm; standard deviation [SD], 1.09\u2009mm). The closest tendon for 4-MH portal is ring finger EDC (mean distance, 2.65\u2009mm; range, 0\u20135.89\u2009mm; SD, 1.78\u2009mm), while 5-MH portal and accessory portal were closest to EDC (mean distance, 1.88\u2009mm; range, 0\u20133.69\u2009mm; SD, 1.25\u2009mm) and EDM (mean distance, 7.79\u2009mm; range, 6.63\u201310.72\u2009mm; SD, 1.49\u2009mm), respectively. During the process of specimen dissection, we found no damage to the above structures after portal introduction.<\/jats:p><jats:p>\n          Conclusion\u2003The above findings support the use of fifth CMCJ arthroscopy, which can be used for assisted reduction in fifth metacarpal base fracture dislocation and hamate body fracture. Gentle soft tissue spreading technique during portal creation prevents injury to the important structure surrounding the portals.<\/jats:p><jats:p>\n          Level of evidence\u2003This is a Level V study.<\/jats:p>","DOI":"10.1055\/s-0041-1740485","type":"journal-article","created":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T23:36:04Z","timestamp":1641512164000},"page":"155-160","source":"Crossref","is-referenced-by-count":0,"title":["Is It Possible to Perform Fifth Carpometacarpal Joint Arthroscopy? Cadaveric Study on Its Feasibility, Safety, and Potential Hazards in Portal Creation"],"prefix":"10.1055","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0425-4222","authenticated-orcid":false,"given":"Siu Cheong Jeffrey Justin","family":"Koo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Alice Ho Miu Ling Nethersole Hospital, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pak Cheong","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,1,6]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1016\/S0363-5023(79)80070-2","article-title":"The mechanism of dorsal fracture dislocation of the fifth carpometacarpal joint","volume":"4","author":"M Lilling","year":"1979","journal-title":"J Hand Surg Am"},{"issue":"01","key":"ref2","first-page":"52","article-title":"Advances in arthroscopic surgery of the wrist: from resection to reconstruction","volume":"51","author":"P C Ho","year":"2015","journal-title":"Medicina fluminensis"},{"key":"ref3","first-page":"321","volume-title":"Small joint arthroscopy","author":"A Badia","year":"2015"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1055\/s-0040-1719039","article-title":"Comparing outcomes between arthroscopic-assisted reduction and fluoroscopic reduction in AO type C distal radius fracture treatment","volume":"10","author":"S CJJ Koo","year":"2021","journal-title":"J Wrist Surg"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.hcl.2011.05.010","article-title":"Arthroscopic reduction and percutaneous fixation of fifth carpometacarpal fracture dislocations","volume":"27","author":"D J Slutsky","year":"2011","journal-title":"Hand Clin"},{"issue":"02","key":"ref6","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S1058-2746(09)80110-9","article-title":"Arthroscopy of the elbow joint: a cadaveric study of portal placement","volume":"3","author":"L Adolfsson","year":"1994","journal-title":"J Shoulder Elbow Surg"},{"issue":"04","key":"ref7","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/0749-8063(95)90200-7","article-title":"Arthroscopy of the elbow: anatomy, portal sites, and a description of the proximal lateral portal","volume":"11","author":"K Stothers","year":"1995","journal-title":"Arthroscopy"},{"issue":"08","key":"ref8","first-page":"21","article-title":"Anatomical study of the ankle joint in relation to the anterior, the posterior and the (new) medial arthroscopic portals: a cadaveric study","volume":"9","author":"K B Vaishaly","year":"2017","journal-title":"Int J Curr Res Rev"},{"issue":"391","key":"ref9","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1097\/00003086-200110000-00010","article-title":"Complications in foot and ankle arthroscopy","author":"R D Ferkel","year":"2001","journal-title":"Clin Orthop Relat Res"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.otsr.2016.09.026","article-title":"Cadaver study of anatomic landmark identification for placing ankle arthroscopy portals","volume":"103","author":"B Scheibling","year":"2017","journal-title":"Orthop Traumatol Surg Res"},{"issue":"05","key":"ref11","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/0736-4679(92)90138-J","article-title":"Hamate-metacarpal fracture dislocation","volume":"10","author":"H D Kerr","year":"1992","journal-title":"J Emerg Med"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"447","DOI":"10.2174\/1874325001711010447","article-title":"Fracture of the body of the hamate with dorsal dislocation of the 4th and 5th metacarpals: a case report","volume":"11","author":"V Athanasiou","year":"2017","journal-title":"Open Orthop J"},{"issue":"05","key":"ref13","first-page":"363","article-title":"\u201cArthroplastie stabilis\u00e9e\u201d du cinqui\u00e8me m\u00e9tacarpien. Proposition th\u00e9rapeutique pour le traitement des fractures-luxations anciennes du 5e m\u00e9tacarpien","volume":"13","author":"T Dubert","year":"1994","journal-title":"Ann Chir Main Memb Super"}],"container-title":["Journal of Wrist Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0041-1740485.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:44:22Z","timestamp":1678754662000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0041-1740485"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,6]]},"references-count":13,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2023,3,13]]},"published-print":{"date-parts":[[2023,4]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0041-1740485","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2163-3916","2163-3924"],"issn-type":[{"type":"print","value":"2163-3916"},{"type":"electronic","value":"2163-3924"}],"subject":[],"published":{"date-parts":[[2022,1,6]]}}}