The Mechanism of the First Carpometacarpal (CMC) Joint: An Anatomical and Mechanical Analysis

Pieron, A. P.

doi:10.3109/ort.1973.44.suppl-148.01

Cited by 79 publications

(48 citation statements)

References 9 publications

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“…In a comprehensive marker-based thumb motion study, Tang et al [31] also reported that the first metacarpal generally moves in a direction that is oblique to the anatomy of the CMC joint. In addition, our finding that internal/external rotation of the metacarpal was coupled with flexion/extension and adduction/abduction simultaneously is in agreement with findings from other studies that have reported the flexion/extension and the adduction/ abduction axes as primary axes of motion at the CMC joint and internal/external rotation as a secondary axis of rotation that is coupled with the previous two [8,9,13,15,29].…”

Section: Discussionsupporting

confidence: 82%

In Vivo Kinematics of the Thumb Carpometacarpal Joint During Three Isometric Functional Tasks

Halilaj

Rainbow

Got

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background The thumb carpometacarpal (CMC) joint is often affected by osteoarthritis-a mechanically mediated disease. Pathomechanics of the CMC joint, however, are not thoroughly understood due to a paucity of in vivo data. Questions/purposes We documented normal, in vivo CMC joint kinematics during isometric functional tasks. We hypothesized there would be motion of the CMC joint during these tasks and that this motion would differ with sex and age group. We also sought to determine whether the rotations at the CMC joint were coupled and whether the trapezium moved with respect to the third metacarpal. Methods Forty-six asymptomatic subjects were CT-scanned in a neutral position and during three functional tasks (key pinch, jar grasp, jar twist), in an unloaded and a loaded position. Kinematics of the first metacarpal, third metacarpal, and the trapezium were then computed. Results Significant motion was identified in the CMC joint during all tasks. Sex did not have an effect on CMC joint kinematics. Motion patterns differed with age group, but these differences were not systematic across the tasks. Rotation at the CMC joint was generally coupled and posture of the trapezium relative to the third metacarpal changed significantly with thumb position. Conclusions The healthy CMC joint is relatively stable during key pinch, jar grasp, and jar twist tasks, despite sex and age group. Clinical Relevance Our findings indicate that directionally coupled motion patterns in the CMC joint, which lead to a specific loading profile, are similar in men and women. These patterns, in addition to other, nonkinematic influences, especially in the female population, may contribute to the pathomechanics of the osteoarthritic joint.

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Section: Discussionsupporting

confidence: 82%

In Vivo Kinematics of the Thumb Carpometacarpal Joint During Three Isometric Functional Tasks

Halilaj

Rainbow

Got

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…Many studies of these ligaments have been done by direct or roentgenographic observation (3,8,12,13,17,18,22). In this study, the increase in laxity as a result of ligament sectioning was examined kinematically.…”

Section: Discussionmentioning

confidence: 99%

“…Pellegrini (20) showed the correlation of articular wear with attenuation of the "beak ligament"; this refers to the insertion of the strong ligaments into the volar beak of the first metacarpal, which may include the anterior oblique ligament, first intermetacarpal ligament, and ulnar collateral ligament. In our previous work (13), we used the convention of Pieron (22) to identify the individual ligaments.…”

mentioning

confidence: 99%

Kinematics of the trapeziometacarpal joint after sectioning of ligaments

Imaeda

Niebur

et al. 1994

Journal Orthopaedic Research

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This study was designed to examine the roles of ligaments in the maintenance of the articular kinematics of the trapeziometacarpal joint. Circumduction of the trapeziometacarpal joint was studied in 12 hands from fresh human cadavera. With use of a magnetic tracking system, changes in the motion of the base of the first metacarpal after ligament sectioning were analyzed and compared with those of the normal joint. Two sets of ligaments were sectioned: (a) the anterior oblique and ulnar collateral ligaments and (b) the first intermetacarpal ligament and the ulnar joint capsule. Sectioning of the anterior oblique and ulnar collateral ligaments resulted in a significant dorsal-ulnar shift in the path of the base of the first metacarpal. However, sectioning of the first intermetacarpal ligament did not affect the movement pattern of the center of the base. The anterior oblique and ulnar collateral ligaments provided constraint of the trapeziometacarpal joint during circumduction of the thumb.

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“…Despite much interest in human thumb movements there is no agreement regarding their terminology or mechanics (for review see Gedda, 1954;Pieron, 1973 and recent French papers: Kapandji, 1972;Duparc, Caffiniere & Pineau, 1971). Possibly the position would be clarified if the three joints of the thumb were treated as a functional unit, for there is considerable variation in the contribution which each joint makes to the total movement in different subjects.…”

Section: Introductionmentioning

confidence: 99%

Carpometacarpal joint of the human thumb

Kuczynski¹

1975

Plastic and Reconstructive Surgery

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The Mechanism of the First Carpometacarpal (CMC) Joint: An Anatomical and Mechanical Analysis

Cited by 79 publications

References 9 publications

In Vivo Kinematics of the Thumb Carpometacarpal Joint During Three Isometric Functional Tasks

In Vivo Kinematics of the Thumb Carpometacarpal Joint During Three Isometric Functional Tasks

Kinematics of the trapeziometacarpal joint after sectioning of ligaments

Carpometacarpal joint of the human thumb

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