Comparison of the Anatomical Dimensions and Mechanical Properties of the Dorsoradial and Anterior Oblique Ligaments of the Trapeziometacarpal Joint

D’Agostino, Priscilla; Kerkhof, Faes; Shahabpour, Maryam; Moermans, Jean Pierre; Stockmans, François; Vereecke, Evie

doi:10.1016/j.jhsa.2014.02.025

Cited by 48 publications

(52 citation statements)

References 32 publications

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“…As described, but not quantified, by Edmunds: “During the screw‐home torque phase of opposition, the anterior oblique ligament is completely lax and thus plays no role in prevention of dorsal subluxation, while there is a tensioning of the dorsal ligament complex, coupled to muscles action in the last phase of opposition, which drives the volar beak of the MC1 into its recess in the trapezium for rigid stability”. The important stabilizing function of the dorsal ligaments is also supported by recent studies …”

Section: Discussionsupporting

confidence: 52%

“…We calculated a mean axial rotation of the MC1 of 13° during these movements, which supports the existence of a screw‐home mechanism at the TMC joint. It is hypothesized that the coupling of axial rotation with MC1 flexion has an important stabilizing effect on the TMC joint because pronation of the MC1 leads to tightening of the dorsal ligaments . As described, but not quantified, by Edmunds: “During the screw‐home torque phase of opposition, the anterior oblique ligament is completely lax and thus plays no role in prevention of dorsal subluxation, while there is a tensioning of the dorsal ligament complex, coupled to muscles action in the last phase of opposition, which drives the volar beak of the MC1 into its recess in the trapezium for rigid stability”.…”

Section: Discussionmentioning

confidence: 99%

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In vivo kinematics of the thumb during flexion and adduction motion: Evidence for a screw-home mechanism

et al. 2016

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The thumb plays a crucial role in basic hand function. However, the kinematics of its entire articular chain have not yet been quantified. Such investigation is essential to improve our understanding of thumb function and to develop better strategies to treat thumb joint pathologies. The primary objective of this study is to quantify the in vivo kinematics of the trapeziometacarpal (TMC) and scaphotrapezial (ST) joints during flexion and adduction of the thumb. In addition, we want to evaluate the potential coupling between the TMC and ST joints during these tasks. The hand of 16 asymptomatic women without signs of thumb osteoarthritis were CT scanned in positions of maximal thumb extension, flexion, abduction, and adduction. The CT images were segmented and three-dimensional surface models of the radius, scaphoid, trapezium, and the first metacarpal were created for each thumb motion. The corresponding rotations angles, translations, and helical axes were calculated for each sequence. The analysis shows that flexion and adduction of the thumb result in a three-dimensional rotation and translation of the entire articular chain, including the trapezium and scaphoid. A wider range of motion is observed for the first metacarpal, which displays a clear axial rotation. The coupling of axial rotation of the first metacarpal with flexion and abduction during thumb flexion supports the existence of a screw-home mechanism in the TMC joint. In addition, our results point to a potential motion coupling between the TMC and ST joints and underline the complexity of thumb kinematics. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:1556-1564, 2017.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

In vivo kinematics of the thumb during flexion and adduction motion: Evidence for a screw-home mechanism

et al. 2016

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“…In tandem with the recent skepticism on the role of the AOL, new evidence has emerged on the sturdiness and superior stabilizing potential of the DRL (Bettinger et al, 2000, 1999; Colman et al, 2007; D’Agostino et al, 2014; Hagert et al, 2012; Ladd et al, 2012; Strauch et al, 1999, 1994; Tan et al, 2011; Van Brenk et al, 1998; Zhang et al, 2013). The DRL is located on the dorsal-radial side of the CMC joint, opposite the AOL, and is described by these studies as the most robust ligamentous structure in the joint.…”

Section: Introductionmentioning

confidence: 99%

“…In vivo studies should provide further insight into the role of each of these two ligaments on the stability of the active joint. Several studies have identified the major CMC joint ligaments with MRI and ultrasound (Cardoso et al, 2009; D’Agostino et al, 2014; Gondim Teixeira et al, 2011), without providing a quantitative analysis of their function. There is a limited number of published in vivo studies (Tan et al, 2011) that have explored the roles of these ligaments on joint stability, mainly because assessing ligament function in vivo remains challenging.…”

Section: Introductionmentioning

confidence: 99%

In vivo recruitment patterns in the anterior oblique and dorsoradial ligaments of the first carpometacarpal joint

Halilaj

Rainbow

Moore

et al. 2015

Journal of Biomechanics

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The anterior oblique ligament (AOL) and the dorsoradial ligament (DRL) are both regarded as mechanical stabilizers of the thumb carpometacarpal (CMC) joint, which in older women is often affected by osteoarthritis. Inferences on the potential relationship of these ligaments to joint pathomechanics are based on clinical experience and studies of cadaveric tissue, but their function has been studied sparsely in vivo. The purpose of this study was to gain insight into the functions of the AOL and DRL using in vivo joint kinematic data. The thumbs of 44 healthy subjects were imaged with a clinical computed tomography scanner in functional-task and thumb range-of-motion positions. The origins and insertion sites of the AOL and the DRL were identified on the 3D bone models and each ligament was modeled as a set of three fibers whose lengths were the minimum distances between insertion sites. Ligament recruitment, which represented ligament length as a percentage of the maximum length across the scanned positions, was computed for each position and related to joint posture. Mean AOL recruitment was lower than 91% across the CMC range of motion, whereas mean DRL recruitment was generally higher than 91% in abduction and flexion. Under the assumption that ligaments do not strain by more than 10% physiologically, our findings of mean ligament recruitments across the CMC range of motion indicate that the AOL is likely slack during most physiological positions, whereas the DRL may be taut and therefore support the joint in positions of CMC joint abduction and flexion.

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“…Strauch et al 30 and Bettinger et al 24 studied acute dislocation of the thumb CMC joint and reported that the DRL was the primary restraint to dorsal dislocation of the thumb metacarpal at the thumb CMC joint. In their anatomic and biomechanical studies, Najima et al 27 and D'Agostino et al 25 reported that the DRL was the strongest and stiffest of the thumb CMC ligaments and the main stabilizer of the thumb CMC joint. Pellegrini 29 and Bettinger et al 24 reported that the dAOL is important in the stability of the thumb CMC joint.…”

Section: Resultsmentioning

confidence: 99%

Novel Modification of Abductor Pollicis Longus Suspension Arthroplasty with Trapeziectomy for Thumb Carpometacarpal Osteoarthritis

et al. 2019

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Background:We compared the clinical results of a newly modified abductor pollicis longus (APL) suspension arthroplasty with trapeziectomy procedure (modified Thompson procedure) with those of the original APL suspension arthroplasty with trapeziectomy procedure (original Thompson procedure) for treatment of advanced osteoarthritis of the thumb carpometacarpal (CMC) joint and assessed the effectiveness of the modified Thompson procedure for thumb CMC osteoarthritis.Methods: Ten hands of 10 patients (Group 1) were treated with the original Thompson procedure.Twenty hands of 16 patients (Group 2) were treated with the modified Thompson procedure, in which the bone tunnel positions were rearranged for a more dorsoradial passage of the transferred APL.Results: Significant differences between values before and after surgery were noted in thumb palmar and radial abduction angles, pinch power, grip strength, Quick Disability of Arm, Shoulder, and Hand questionnaire (Quick DASH) score, and visual analog scale (VAS) score. There was no statistically significant difference in thumb palmar abduction angle, pinch power, grip strength, Quick DASH score, or VAS score between Groups 1 and 2. However, range of motion of radial abduction in the thumb was significantly better for patients in Group 2 than for those in Group 1. Conclusions:The modified Thompson procedure is a simple, effective technique that results in greater improvement in thumb radial abduction angle, as compared with the original technique, in patients with advanced thumb CMC osteoarthritis. Additionally, the modified technique is as useful as the original procedure for early restoration of thumb function and pain relief. (J Nippon Med Sch 2019; 86: 269 278)

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Comparison of the Anatomical Dimensions and Mechanical Properties of the Dorsoradial and Anterior Oblique Ligaments of the Trapeziometacarpal Joint

Cited by 48 publications

References 32 publications

In vivo kinematics of the thumb during flexion and adduction motion: Evidence for a screw-home mechanism

In vivo kinematics of the thumb during flexion and adduction motion: Evidence for a screw-home mechanism

In vivo recruitment patterns in the anterior oblique and dorsoradial ligaments of the first carpometacarpal joint

Novel Modification of Abductor Pollicis Longus Suspension Arthroplasty with Trapeziectomy for Thumb Carpometacarpal Osteoarthritis

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