Trapeziometacarpal Joint Stability: The Evolving Importance of the Dorsal Ligaments

Abstract

The dorsal ligaments are the primary stabilizers of the TMC joint. Ligament reconstruction and metacarpal osteotomy ameliorate ligamentous laxity and relieve pain based on Level IV studies.

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

“…Additionally, the presence of the hormone relaxin, which is associated with ligament loosening, has been found in this ligament and has been correlated with joint laxity (Lubahn et al, 2006; Wolf et al, 2013a, 2013b). Recent studies, however, have reported structural limitations of the AOL that challenge the importance of its role on joint stability (Colman et al, 2007; Hagert et al, 2012; Ladd et al, 2012; Lin et al, 2013; Strauch et al, 1999). …”

Rhizarthrose

“…Auf konventionellen Röntgenaufnah-men sind die Ligamente nicht visualisierbar, sie scheinen aber im Hinblick auf eine Instabilität des DSG und die Pathogenese der Rhizarthrose von maßgeblicher Bedeutung zu sein [15,21].…”

“…Das DRL bildet durch seinen breiten Ursprung und seine dicke Morphologie eine Barriere gegen dorsoradiale Subluxationskräfte [5,15,21].…”

Dorsoradial Ligament Imbrication for Thumb Carpometacarpal Joint Instability

“…3,4 CMC instability and ligamentous laxity can be caused by many factors, including prior trauma 5 and connective disorders such as Ehlers-Danlos syndrome. [11][12][13][14][15] Since its description by Eaton and Littler in 1973, 7,16 the Eaton-Littler procedure has been the classic treatment of thumb CMC joint instability, utilizing half the FCR tendon passed volar to dorsal though the base of the first metacarpal. However, which of these ligaments serves as the primary stabilizer of the joint has been a source of debate.…”