Document Detail


Effects of the deep anterior oblique and dorsoradial ligaments on trapeziometacarpal joint stability.
MedLine Citation:
PMID:  17336836     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Osteoarthritis of the trapeziometacarpal (TMC) joint of the thumb affects as many as 25% of postmenopausal women and 5% of middle-aged men. This study investigated the relative contribution of the dorsoradial ligament (DRL) and the deep anterior oblique ligament (dAOL) to the stability of the TMC joint. This knowledge will improve our understanding of the pathomechanics of osteoarthritis at the base of the thumb and may help to design novel reconstructive surgical procedures. METHODS: Seventeen intact cadaver hands were dissected to reveal the DRL and dAOL. Either the DRL or dAOL was transected randomly, physiologic muscle loads were applied to simulate lateral key pinch or thumb opposition, or a 3-dimensional magnetic tracking system was used to record the position of the thumb metacarpal relative to the trapezium. The differences in the 3-dimensional positions between the control and transected states were determined. RESULTS: In lateral pinch, transection of the DRL resulted in a mean increased 3-dimensional translation of 1.3 mm, whereas transection of the dAOL resulted in a mean increased 3-dimensional translation of 0.6 mm. Statistically significant 2-dimensional findings in lateral pinch after transecting the DRL or dAOL included an increased palmar subluxation of 0.3 mm and 0.2 mm, an increased radial (1.0 mm) and ulnar (0.3 mm) translation, and an increased pronation of 4.1 degrees and 2.4 degrees, respectively. In thumb opposition, transection of the DRL resulted in a mean increased 3-dimensional translation of 1.0 mm, whereas transection of the dAOL resulted in a mean increased 3-dimensional translation of 0.5 mm. CONCLUSIONS: In most degrees of freedom of metacarpal movement relative to the trapezium, the DRL is relatively more important than the dAOL in providing stability to the TMC joint.
Authors:
Matthew Colman; Daniel P Mass; Louis F Draganich
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  32     ISSN:  0363-5023     ISO Abbreviation:  J Hand Surg Am     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-05     Completed Date:  2007-04-17     Revised Date:  2009-06-08    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  310-7     Citation Subset:  IM    
Affiliation:
Section of Orthopedics and Rehabilitative Medicine, Department of Surgery, University of Chicago, Chicago, IL, USA.
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MeSH Terms
Descriptor/Qualifier:
Finger Joint / physiology*,  physiopathology
Humans
Joint Instability / physiopathology
Ligaments, Articular / physiology*,  physiopathology
Osteoarthritis / physiopathology
Pinch Strength / physiology
Random Allocation
Suture Techniques
Thumb / physiology*,  physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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