Sonography of the Anterior Oblique Ligament of the Trapeziometacarpal Joint: A Study of Cadavers and Asymptomatic Volunteers

Abstract

High-resolution ultrasound can be used to identify and measure the thickness of the anterior oblique ligament. Dynamic ultrasound imaging can depict volar translation of the metacarpal, which may facilitate diagnosis of ligamentous injury.

Sonography of trapezial ridge fractures

“…Bettinger et al described 16 ligaments for stabilizing the first carpometacarpal ligament with the majority (14) of them inserting on the trapezium . The anterior oblique ligament spanning between the volar surface of the trapezium and volar surface of the base of first metacarpal is one of the key stabilizing ligaments …”

“…12 The anterior oblique ligament spanning between the volar surface of the trapezium and volar surface of the base of first metacarpal is one of the key stabilizing ligaments. 13 Fractures of carpal bones account for 6% of all fractures with the majority involving the scaphoid. 2 Fractures of trapezium are uncommon, accounting for 2-5% of all carpal fractures.…”

Ultrasound of Normal and Injured Ligaments and Retinacula of the Hand

“…11,[44][45][46] The AOL includes both superficial and deep ligaments that span around the volar TMC joint and run in a diagonal fashion from proximal-radial to distal-ulnar. 11,44,45 The wide superficial AOL originates from the volar tubercle of the trapezium and inserts broadly onto the volar tubercle of the first metacarpal. The shorter and narrower intra-articular deep AOL attaches along the articular margin of the trapezium and inserts onto the beaked volar base of the first metacarpal.…”

“…The term beak ligament is used to refer to either the total AOL complex or the deep portion specifically. 11,44,45 The AOL shares an intimate relationship with the UCL, which is extracapsular, originating proximally from the flexor retinaculum insertion onto the trapezial ridge and attaching on the volar ulnar tubercle of the first metacarpal base close to the intermetacarpal ligament. 44 The UCL inserts superficial and ulnar to the AOL, typically overlapping the superficial AOL by 2 to 3 mm.…”

“…The AOL was confidently visualized with US in 98 to 100% of asymptomatic volunteers. 44,45 The AOL is best evaluated with the palm facing up and the thumb maintained in extension and abduction. The transducer is placed onto the thenar eminence, parallel to the first metacarpal, and centered on the volar ulnar aspect of the TMC joint in the longitudinal plane.…”