Biomechanics of the Trapeziometacarpal Joint

Zancolli, E; Ziadenberg, Carlos; Zancolli, E

doi:10.1097/00003086-198707000-00004

Cited by 84 publications

(71 citation statements)

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“…1,23 The coordination within the CMC joint may be attributable to the line of tendon force, 17,25 joint surface configuration, 23 and ligament constraint. 26 Hollister and colleagues 23 argued that the intrajoint coordination at the CMC and MCP joints is mainly due to the thumb joints having axes of rotation that are offset from the anatomical planes, leading to conjunct movements. 23 We found that the APL, EPB, and EPL generated axial rotation (i.e., supination) at the CMC joint, although the rotation was coupled with movements in other planes.…”

Section: Discussionmentioning

confidence: 99%

Complex, multidimensional thumb movements generated by individual extrinsic muscles

Tang

Chakan

et al. 2008

Journal Orthopaedic Research

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The objective of this study was to investigate three-dimensional thumb joint movements produced by individual extrinsic thumb muscles. Ten cadaveric arms were dissected to expose the musculotendinous junctions of the flexor pollicis longus (FPL), abductor pollicis longus (APL), extensor pollicis brevis (EPB), and extensor pollicis longus (EPL). Each muscle/tendon was loaded to 10% of its maximal force capability whereas three-dimensional angular movements of the carpometacarpal (CMC), metacarpophalangeal (MCP), and interphalangeal (IP) joints were obtained simultaneously. We found that each extrinsic muscle produced unique joint angular trajectories in multiple directions. The FPL, APL, EBP, and EPL generated two, two, three, and six movements, respectively. The extrinsic muscles all together generated eight movements among the multiple thumb joints. High interjoint coordination was shown between the MCP joint flexion and IP joint flexion by FPL loading, as well as between the MCP joint extension and IP joint extension by EPL loading. High intrajoint coordination was observed between extension and supination at the CMC joint by the APL, EPL, and EPB. We concluded that each muscle produces movements in multiple joints and/or in multiple anatomical directions. The findings provide a novel insight into the biomechanical roles of the extrinsic muscles of the thumb. The human thumb is exceptionally mobile, strong, and dexterous partially due to its sophisticated musculature. Kinematically, thumb motion results from complicated combinations of flexion/extension, abduction/ adduction, and pronation/supination (i.e., axial rotation) at the carpometacarpal (CMC), metacarpophalangeal (MCP), and interphalangeal (IP) joints. 1,2 The movement capability of the thumb was previously determined by measuring the linear distance between the thumb tip and the fingertips or other anatomical landmarks, 3,4 but thumb pathology can be characterized by examining the angular motion at the individual joints. Manual goniometry is commonly used in the clinic to evaluate statically joint mobility in a single plane. Electrogoniometers can be used to monitor dynamic joint motion, 5 but they can be too bulky to record simultaneous movements from multiple joints within the thumb and can interfere with delicate thumb movements. X-rays, 1,6 and CT 7 have been used to study in vivo thumb kinematics, but the amount of kinematic information is limited. Recently, noninvasive, marker-based video methods have been used to study advanced kinematic features thus providing a more accurate representation of thumb motion. 2,[8][9][10][11] Marker-based motion analyses were applied to study thumb pathokinematics in individuals with cervical myelopathy 12 and lower median nerve block; 13 the authors reported aberrant thumb kinematics during pinch movements.Thus far, our understanding of thumb motion by each muscle remains dominated by basic functional anatomy using unidirectional, simplified nomenclature such as flexors or extensors. Therefore, this ...

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Section: Discussionmentioning

confidence: 99%

Complex, multidimensional thumb movements generated by individual extrinsic muscles

Tang

Chakan

et al. 2008

Journal Orthopaedic Research

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“…1) [26,108]. The concavoconvex saddle trapezial surface creates ''reciprocal reception'' [44] with the metacarpal to permit wide circumduction.…”

Section: Functional Morphologymentioning

confidence: 99%

“…We performed a complementary micro-CT study [48] evaluating quadrant [26,108] trabecular characteristics in the trabecular midregion bone of 13 normal and 16 arthritic trapeziae from patients with mean ages of 69 and 61 years, respectively and male-to-female ratios of 4:9 and 10:6, respectively [64]. ANOVA with post hoc Bonferroni/Dunn correction revealed no difference in bone volume fraction between the OA and normal specimens (p = 0.31) although OA trapeziae demonstrated higher trabecular number (p = 0.025) and connectivity (p = 0.018) than non-OA trapeziae.…”

Section: Microscopicmentioning

confidence: 99%

“…At the discrete level of the CMC joint, the micromotion has been theorized [16,36,77,108] but not quantified in humans, especially as a 3-D concept. Video capture with cine fluoroscopy provides high-resolution, albeit highradiation-linked, radiographs, whereas mini-image intensifiers provide fast imaging capabilities with resolution sacrifice (Fig.…”

Section: Fine Motormentioning

confidence: 99%

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The 2014 ABJS Nicolas Andry Award: The Puzzle of the Thumb: Mobility, Stability, and Demands in Opposition

Ladd

Crisco

Hagert

et al. 2014

Clin Orthop Relat Res

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“…By attaching along the radial border of the first metacarpal, this muscle flexes and medially rotates the thumb, helping to guide the articular surface of the metacarpal through a groove on the transverse articular surface of the trapezium. 75 Although maximal in opposition, only 53% of the surface area of the trapezium is in contact with the metacarpal. 45 Full opposition incorporates at least 45°to 60°of medial rotation of the thumb.…”

Section: Structural and Functional Considerationsmentioning

confidence: 99%

The Carpometacarpal Joint of the Thumb: Stability, Deformity, and Therapeutic Intervention

Neumann¹,

Bielefeld²

2003

J Orthop Sports Phys Ther

123

114

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Biomechanics of the Trapeziometacarpal Joint

Cited by 84 publications

References 0 publications

Complex, multidimensional thumb movements generated by individual extrinsic muscles

Complex, multidimensional thumb movements generated by individual extrinsic muscles

The 2014 ABJS Nicolas Andry Award: The Puzzle of the Thumb: Mobility, Stability, and Demands in Opposition

The Carpometacarpal Joint of the Thumb: Stability, Deformity, and Therapeutic Intervention

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