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

Halilaj, Eni; Rainbow, Michael J.; Moore, Douglas C.; Laidlaw, David H.; Weiss, Arnold‐Peter C.; Ladd, Amy L.; Crisco, Joseph J.

doi:10.1016/j.jbiomech.2015.04.028

Cited by 33 publications

(35 citation statements)

References 45 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%

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%

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 assumption underlying this method was that the final static orientation and position of the metacarpal is a result of the combined muscle, joint contact, and ligament forces. However, ligament contribution to this force is thought to be minimal, as prior studies show TMC ligaments to be lax during the ranges of motion studied [28]. Since the TMC cartilage was not visible in the CT images, we represented cartilage as a uniform thickness of 0.7 mm with neo-hookean properties.…”

Section: Discussionmentioning

confidence: 99%

“…The resultant force vector of all external forces onto the joint was passed through the centroid of the first metacarpal towards the trapezium to bring the two cartilage surfaces into contact. We assumed no contribution from ligaments during these postures [28]. …”

Section: Methodsmentioning

confidence: 99%

Trapeziometacarpal joint contact varies between men and women during three isometric functional tasks

Schneider

Zhang

Crisco

et al. 2017

Medical Engineering & Physics

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Trapeziometacarpal (TMC) joint osteoarthritis (OA) affects women two to six times more than men, and is influenced by stresses and strains in the cartilage. The purpose of this study was to characterize sex and age differences in contact area and peak stress location of the healthy TMC joint during three isometric tasks including pinch, grasp and jar twist. CT images of the hand from 50 healthy adult men and women were used to create a statistical shape model that was used to create finite element models for each subject and task. Forcedriven simulations were performed to evaluate cartilage contact area and peak stress location. We tested for sex and age differences using principal component analysis, linear regression, and linear discriminant analysis. We observed sex differences in peak stress location during pinch (p=0.0206), grasp (p=0.0264), and jar twist (p=0.0484). The greatest sex differences were observed during jar twist, where 94% of peak stresses in men were located in the centre compared with 50% in the central-volar region in women. These findings show that peak stress locations are more variable in women during grasp and jar twist than men, and suggest that women may employ different strategies to perform these tasks.

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“…Additionally, both the DRL and SAOL lengthened during adduction of the first CMC joint and both the POL and dAOL lengthened during abduction of the joint. Halilaj et al 5 also evaluated the changes in the lengths of the DRL and AOL during the first CMC motions using in vivo kinematics data. They indicated that the AOL was slack in most of the range of CMC joint motion, whereas the DRL was in tension in positions that involve joint flexion and adduction, similar to our findings.…”

Section: -12mentioning

confidence: 99%

“…1 Therefore, the first CMC ligaments are thought to play an important role in the maintenance and stability of the first CMC joint. [2][3][4][5][6][7][8][9][10][11][12] Currently, several studies on the anatomy of the first CMC ligaments have been reported in cadaveric dissections. 2,6,[8][9][10][13][14][15] Presently, Bettinger et al 2 and Nanno et al 8 have described seven ligaments in examining the complex ligamentous anatomy of both the first metacarpal and the trapezium.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional dynamic motion analysis of the first carpometacarpal ligaments

Nanno

Kodera

Tomori

et al. 2017

J Orthop Surg (Hong Kong)

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Purpose: The purpose of this study was to analyze the dynamic motion of the first carpometacarpal (CMC) ligaments on a three-dimensional (3-D) surface model and to examine the changes in the ligament lengths during the motion of the first CMC joint. Methods: Six fresh-frozen cadaver wrists were used to analyze the motion of the first CMC ligaments on a 3-D coordinate system using a digitizer. Four ligaments, namely, dorsoradial ligament (DRL), posterior oblique ligament (POL), superficial anterior oblique ligament (SAOL), and deep anterior oblique ligament (dAOL), were dissected and identified. Their attachments were digitized and represented on 3-D bone images. The distances between the ligament attachments of the first metacarpal and the trapezium, which were the ligament lengths, were measured during the extension-flexion and adduction-abduction of the first CMC joint. Results: Both the DRL and POL lengthened during flexion of the first CMC joint, and both the SAOL and dAOL lengthened during extension. Both the DRL and SAOL lengthened during adduction, and both the POL and dAOL lengthened during abduction. The DRL alone lengthened significantly at flexion and adduction when the first CMC joint was in dorsoradial dislocation. Conclusions: The lengths of four ligaments changed significantly during first CMC joint motion. This study suggested that the DRL contributes substantial stability to the first CMC joint, preventing dorsoradial dislocation. This 3-D information improves the knowledge and understanding of the function of individual ligaments and their roles in the stability of the first CMC joint.

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

Cited by 33 publications

References 45 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

Trapeziometacarpal joint contact varies between men and women during three isometric functional tasks

Three-dimensional dynamic motion analysis of the first carpometacarpal ligaments

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