Evaluation of Hand Morphometry in Healthy Young Individuals from Different Countries / Evaluación de la Morfometría de la Mano en Individuos Jóvenes Sanos de Diferentes Países

SUMMARY: This study aims to examine the hand morphometry of healthy young individuals from different countries and investigate the differences between countries in typing of hand based on the morphometric values obtained. In the study, 16 different parameters, including two surface areas and 14 lengths, were measured from the right hand of 579 volunteers (250 females, 329 males) from 7 different countries (Turkey, Chad, Morocco, Gabon, Kazakhstan, Senegal and Syria). Factor analysis was performed on the parameters, cluster analysis was performed according to the factor score obtained, and the hand types in the study were determined. As a result of the study, four different hand types were defined, and the distribution of these types according to countries was analyzed. All parameters showed significant differences between countries in both genders (p<0.05). According to the results of the study, there was a difference between male and female hand types between countries. In females, the type 1 hand type was found only in Gabon, the type 2 hand type was found only in Senegal, the type 3 hand type was found in Turkey, Morocco and Kazakhstan, while the type 4 hand type was significantly distributed in Senegal and Gabon (X2 =104.62; df=18, p<0.05). In males, type 1 hand type was found in Turkey, type 2 hand type in Senegal and Gabon, type 3 hand type in Turkey, while type 4 hand type was significantly distributed in Morocco and Kazakhstan (X2 =76.964; df=18, p<0.05).

Este estudio tuvo como objetivo examinar la morfometría de la mano de individuos jóvenes sanos de diferentes países e investigar las diferencias en la mecanografía de la mano entre países en función de los valores morfométricos obtenidos. En el estudio, se midieron 16 parámetros diferentes, incluidas dos superficies y 14 longitudes, de la mano derecha de 579 voluntarios (250 mujeres, 329 hombres) de 7 países diferentes (Turquía, Chad, Marruecos, Gabón, Kazajstán, Senegal y Siria). Se realizó un análisis factorial de los parámetros, un análisis de conglomerados según la puntuación factorial obtenida y se determinaron los tipos de manos en el estudio. Como resultado, se definieron cuatro tipos diferentes de manos y se analizó la distribución de estos tipos según países. Todos los parámetros mostraron diferencias significativas entre países en ambos sexos (p<0,05). Según los resultados del estudio, hubo una diferencia entre los tipos de manos de los hombres y de las mujeres entre países. En las mujeres, el tipo de mano tipo 1 se encontró solo en Gabón, el tipo de mano tipo 2 se encontró solo en Senegal, el tipo de mano tipo 3 se encontró en Turquía, Marruecos y Kazajstán, mientras que la mano tipo 4 se distribuyó significativamente en Senegal y Gabón (X2=104,62; gl=18, p<0,05). En los hombres, el tipo de mano tipo 1 se encontró en Turquía, el tipo de mano tipo 2 en Senegal y Gabón, el tipo de mano tipo 3 en Turquía, mientras que la mano tipo 4 se distribuyó significativamente en Marruecos y Kazajstán (X2=76,964; gl=18, p <0,05).

Morphology and Morphometry of the Dorsal Interosseous Muscles of the Hand: Laterality and Sexual Dimorphism / Morfología y Morfometría de los Músculos Interóseos Dorsales de la Mano: Lateralidad y Dimorfismo Sexual

SUMMARY: The dorsal interosseous muscles (DIM) are intrinsic muscles of the hand located dorsally between metacarpal bones, which play a role in finger abduction. Anatomical variations of these muscles in terms of form and length have been well documented, but variations regarding sex and laterality are underexplored. The aim of this study was to investigate the morphology and morphometry of the DIM of the hand regarding sexual dimorphism and laterality. Twenty human cadavers belonging to the white individuals (n = 40 hands) with known sex and laterality were used for this study. DIMs were dissected and observed for morphology. Also, a digital calliper was used to measure the midpoint length of the DIM. The origin and insertion of all the DIM were normal with the left hand having no additional, supernumerary, and absent muscles in each compartment. The variations were only found on the right side and predominant in females: 2 out of 11 (18.18%) hands containing a space with a supernumerary muscle; 1 out of 11 (9.09%) hands having a space with a double muscle; and 1 out of 11 (9.09%) hands having a compartment with a unipennate muscle. In males, 1 out of 9 (11.11%) hands had a compartment with a supernumerary muscle. The mean midpoint length of each muscle in females and males in both hands from the first to the fourth muscle, respectively, was documented. In females on the left: 46.79 ± 3.56; 42.62 ± 3.57; 49.02 ± 4.21; 41.66 ± 2.15 and right: 47.30 ± 2.49; 39.27 ± 4.14; 45.69 ± 4.64; 38.12 ± 4.08. In males, it was on the left: 50.01 ± 3.95; 41.98 ± 3.79; 47.90 ± 4.83; 41.79 ± 4.25, and on the right: 46.65 ± 2.09; 39.01 ± 4.25; 47.47 ± 3.41; 38.31 ± 4.40. The mean midpoint length of the DIM was relatively higher on the left hand compared to the right hand in both females and males. In this study, variations regarding the supernumerary muscle, double interosseous space, and unipennate muscles were only observed on the right-hand side and predominantly in females, an insight that may guide in the treatment of fractures, stiffness of the hand, and compartment syndromes.

Los músculos interóseos dorsales (DIM) son músculos intrínsecos de la mano ubicados dorsalmente entre los huesos metacarpianos, que desempeñan un papel en la abducción de los dedos. Las variaciones anatómicas de estos músculos en términos de forma y longitud están bien documentadas, pero las variaciones con respecto al sexo y la lateralidad están poco exploradas. El objetivo de este estudio fue investigar la morfología y morfometría de los DIM de la mano con respecto al dimorfismo sexual y la lateralidad. Para este estudio se utilizaron veinte cadáveres humanos pertenecientes a individuos blancos (n = 40 manos) con sexo y lateralidad conocidos. Los DIM se diseccionaron y observaron para determinar su morfología. Además, se utilizó un calibrador digital para medir la longitud del punto medio del DIM. El origen y la inserción de todos los DIM fueron normales y la mano izquierda no tenía músculos adicionales, supernumerarios y ausentes en cada compartimento. Las variaciones se encontraron sólo en el lado derecho y predominaron en el sexo femenino: 2 de 11 (18,18%) manos contenían un espacio con un músculo supernumerario; 1 de cada 11 (9,09%) manos presentando un espacio con doble músculo; y 1 de cada 11 (9,09%) manos presentaba un compartimento con músculo unipenate. En los hombres, 1 de cada 9 (11.11%) manos tenía un compartimento con un músculo supernumerario. Se documentó la longitud media del punto medio de cada músculo en mujeres y hombres en ambas manos desde el primer al cuarto músculo, respectivamente. En mujeres de izquierda: 46,79 ± 3,56; 42,62 ± 3,57; 49,02 ± 4,21; 41,66 ± 2,15 y derecha: 47,30 ± 2,49; 39,27 ± 4,14; 45,69 ± 4,64; 38,12 ± 4,08. En los varones fue hacia la izquierda: 50,01 ± 3,95; 41,98 ± 3,79; 47,90 ± 4,83; 41,79 ± 4,25, y a la derecha: 46,65 ± 2,09; 39,01 ± 4,25; 47,47 ± 3,41; 38,31 ± 4,40. La longitud media del punto medio del DIM fue relativamente mayor en la mano izquierda en comparación con la derecha tanto en mujeres como en hombres. En este estudio, las variaciones con respecto al músculo supernumerario, el doble espacio interóseo y los músculos unipennados sólo se observaron en el lado derecho y predominantemente en el sexo femenino, un conocimiento que puede guiar en el tratamiento de fracturas, rigidez de la mano y síndromes compartimentales.

Ultrasound identification of hand and wrist anatomical structures by hand surgeons new to ultrasonographic techniques.

PURPOSE: Ultrasound is becoming an essential tool for hand surgeons, but most of them are trained on the job, without any diploma or dedicated training. The aim of this study was to assess the ability of hand surgeons new to ultrasound to identify hand and wrist anatomical structures. METHODS: A monocentric study was conducted from January 2022 to April 2022. Ten residents and five attending hand surgeons, ultrasound novices, were involved in this study. The participants underwent two tests, wherein they were required to identify 17 anatomical structures using ultrasound, on the same subject. The second test was similar and carried out 2 to 6 weeks later by all participants. The number of structures successfully identified and if it was the case, the detection time per structure, were recorded. The correlations between participants age, years of surgical experience, surgical background (orthopedic or plastic) and the ability to perform immediately during the first test or to progress between the two tests were also assessed. RESULTS: The average number of structures identified during the first test (T1) was 14.1+/-2.1 (82.9%), versus 16.2+/-0.8 (95.3%) structures during the second test (T2) (p = 0.001). The mean detection time per structure was 53.4 +/- 18.9 s during T1 versus 27.7 +/- 7.2 s during T2 (p < 0.0001). A moderate negative correlation between the progression in the number of anatomical structures identified between the two tests and the years of surgical experience (ρ=-0.56; p = 0.029) was found. The other parameters were neither correlated with the ability to perform at the first test nor with the progression between the two tests. CONCLUSION: Hand surgeons new to ultrasound are most of the time able to identify hand and wrist anatomical structures. Comparison of their first and second tests showed significant potential for improvement in anatomical structure identification and detection time of those, especially in surgeons with limited surgical experience.

Application of the "Hand as Foot" teaching method in liver Couinaud segmentation.

OBJECTIVE: We aim to provide a teaching method to better explain the liver Couinaud Segmentation teaching. METHOD: Through a deep understanding of the liver Couinaud Segmentation teaching, and after more than 20 years of teaching practice, our department teaching team pioneered "Hand as Foot ". RESULTS: The combined teaching method of "Hand as Foot" can clearly show the liver Couinaud Segmentation teaching. CONCLUSION: Compared with the traditional teaching method, "Hand as Foot" is favored by most teachers and students.