Assessment of Dorsal Subluxation in Thumb Carpometacarpal Osteoarthritis

Miura, Toshiki; Maki, Akira; Tanaka, Shinya; Uehara, Kosuke

doi:10.1055/s-0038-1636730

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…[20] Dorsoradial metacarpal base subluxation have also been tracked in the literature. [20,21] While these measures indicate potential for mobility issues of the thumb metacarpal base after LRTI, in no previously reported case has this resulted in a dislocation.…”

Section: Discussionmentioning

confidence: 99%

Thumb metacarpal dislocation after trapeziectomy with ligamentous reconstruction and tendon interposition: A case report

Weber

Frankenhoff²

2022

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Thumb carpometacarpal (CMC) arthritis is one of the most common and debilitating pathologies evaluated by the hand surgeon, affecting up to 35% of individuals over 55 years of age. Though multifactorial in etiology, dorsal and radial subluxation of the thumb CMC due to incompetency of the volar beak ligament is thought to be among the most important factors contribution to the arthritis. Multiple operative interventions have been proposed to best address this pathology. In the United States, trapeziectomy with ligament reconstruction and tendon interposition (LRTI) as described by Burton and Pellegrini remains the most widely used technique. As an isolated trauma, dislocation of the thumb CMC joint is a rare injury, only comprising approximately 1% of injuries evaluated by hand surgeons. Typically, thumb CMC dislocations occur due to axial load with the thumb in a flexed position. They are most commonly dorsal dislocations, and are thought to occur due to failure of the dorsoradial ligament. To date, no cases of CMC dislocation after LRTI have yet been described in the literature. Here we present a patient with volar thumb CMC dislocation as a rare complication after LRTI. After percutaneous pinning and immobilization followed by hand therapy, the patient has had a successful return to work with improved pain, restored function, and no further instability.

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Section: Discussionmentioning

confidence: 99%

Thumb metacarpal dislocation after trapeziectomy with ligamentous reconstruction and tendon interposition: A case report

Weber

Frankenhoff²

2022

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“…The dorsal subluxation angle is defined as the angle between a tangent drawn on the dorsal side of the first metacarpal and the longitudinal axis of the second metacarpal (Kurosawa et al., 2013) (Figure 6(b)). Another study measures the dorsal subluxation as the overlap between the first metacarpal and second metacarpal base on a lateral Kapandji view (Miura et al., 2018) (Figure 6(c)). Both the dorsal subluxation angle and the first and second metacarpal overlap allow evaluation of the subluxation before and after trapeziectomy because no references are taken on the trapezium.…”

Section: Radiographic Measurements – Osteoarthritismentioning

confidence: 99%

Radiological imaging of the trapeziometacarpal joint: a historical and clinical perspective

Royen

Vanmierlo

et al. 2022

J Hand Surg Eur Vol

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The opposable thumb provides both stability and mobility and is needed to accomplish different prehensile tasks. The trapezium is a complex bone, with a distal articular surface that is convex in the sagittal plane of the thumb and concave in the coronal plane of the thumb. The numerous additional articulations with the carpus and the oblique orientation to the main plane of the hand makes it difficult to evaluate the trapeziometacarpal joint using standard hand or wrist radiographic views. This review gives an overview of the different radiological views that have been described for the thumb with an emphasis on their historical origin and positioning during radiography. We also describe different measurements and classifications that can be obtained using different thumb radiographs.

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“…Unaddressed arthritis may lead to a hyperextension deformity of the metacarpophalangeal (MCP) joint and adduction of the first webspace. 1-4 This results in a reduction in key pinch strength, which diminishes hand function. There are multiple treatments that exist to address MCP hyperextension in the setting of basal joint arthritis.…”

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confidence: 99%

Management of Thumb Metacarpophalangeal Hyperextension in the Setting of Thumb Basal Joint Arthritis

Morrell

Menon

Nolan

2022

J Am Acad Orthop Surg

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Thumb metacarpophalangeal (MCP) joint hyperextension is a wellestablished sequela of advanced carpometacarpal (CMC) joint arthritis. This deformity results in poor patient function because the ability to perform key pinch is negatively affected. For this reason, surgeons must consider the presence of an MCP deformity when addressing CMC arthritis. A variety of nonsurgical and surgical interventions have emerged. Surgical treatments can be grouped into four main categories: (1) volar plate advancement/capsulodesis, (2) tendon transfer and tenodesis, (3) sesamoidesis, and (4) arthrodesis. Surgical intervention is based on both the degree of deformity present and the surgeon preference. This review aims to clarify indications for various treatments of MCP joint hyperextension, outline commonly performed procedures, and report the published outcomes and potential complications of these interventions.T humb carpometacarpal (CMC) joint, or basal joint, arthritis is a common cause of hand pain in the adult population. Unaddressed arthritis may lead to a hyperextension deformity of the metacarpophalangeal (MCP) joint and adduction of the first webspace. [1][2][3][4] This results in a reduction in key pinch strength, which diminishes hand function. There are multiple treatments that exist to address MCP hyperextension in the setting of basal joint arthritis. Surgical interventions include both softtissue and bony procedures. This article focuses on understanding the etiology, progression, and effect MCP hyperextension has on hand function and reviews the various treatments that address it. Carpometacarpal and Metacarpophalangeal Joint AnatomyTreating the MCP hyperextension deformity requires an understanding of the anatomy of both the CMC and MCP joints. The thumb CMC joint is an articulation between the first metacarpal base and the trapezium. The trapezium is an eccentric saddle with concavity in the radioulnar axis and convexity

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Assessment of Dorsal Subluxation in Thumb Carpometacarpal Osteoarthritis

Cited by 3 publications

References 16 publications

Thumb metacarpal dislocation after trapeziectomy with ligamentous reconstruction and tendon interposition: A case report

Thumb metacarpal dislocation after trapeziectomy with ligamentous reconstruction and tendon interposition: A case report

Radiological imaging of the trapeziometacarpal joint: a historical and clinical perspective

Management of Thumb Metacarpophalangeal Hyperextension in the Setting of Thumb Basal Joint Arthritis

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