Distribution patterns of sesamoid bones in the hand: a systematic review and meta-analysis

This study aimed to assess the arrangement of sesamoid bones within the human hand to improve the clinical interpretation of imaging findings, particularly in trauma, hand surgery, and rheumatologic practice.

A large-scale search of major databases (PubMed, Embase, Web of Science, Scopus, CINAHL Ultimate, and ScienceDirect) was conducted without date or language restrictions to identify all relevant studies. The Anatomical Quality Assessment Tool was used to assess the quality of the included studies.

Nine studies comprising 7,018 hands were included. The most frequent pattern was the presence of sesamoid bones exclusively at the first metacarpophalangeal joint (26.07%), with similar prevalence in European (24.25%) and Asian (24.70%) populations. The second most common configuration involved sesamoid bones at both the first and fifth metacarpophalangeal joints (12.77%) and was more frequent in Europe than in Asia. This pattern was followed by the presence of sesamoid bones at the first, second, and fifth metacarpophalangeal joints. Prevalence varied according to sex, laterality, population, and imaging modality, whereas complete absence of sesamoid bones was rare (0.15%).

Distinct distribution patterns of hand sesamoid bones are common and clinically relevant. Recognizing these anatomical variants may improve radiologic assessment and surgical planning. Further studies are needed to standardize imaging and reporting methods.