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J Hand Surg Eur Vol. 2018 Dec;43(10):1088-1097. doi: 10.1177/1753193418789828. Epub 2018 Aug 1.

Quantitative analysis of in-vivo thumb carpometacarpal joint kinematics using four-dimensional computed tomography.

Wang KK1,2, Zhang X2,3, McCombe D2,4, Ackland DC2,3, Ek ET1,2, Tham SK1,2,4.

Author information

1
1 Hand Surgery Unit, Dandenong Hospital, Monash University, Melbourne, Australia.
2
2 Hand and Wrist Biomechanics Laboratory (HWBL), O'Brien Institute, Melbourne, Australia.
3
3 Department of Biomechanical Engineering, University of Melbourne, Melbourne, Australia.
4
4 Hand Surgery Unit, St Vincent's Hospital, Melbourne, Australia.

Abstract

The purpose of this study was to define the normal thumb carpometacarpal joint kinematics in-vivo during opposition and abduction using four-dimensional computed-tomography in four volunteers. Movement of the metacarpal relative to the trapezium was quantified using both Euler and helical axis representations. Articular surface contact patterns were also analysed. The overall axis of rotation for the movement of opposition and abduction passes through the trapezium and the base of the proximal phalanx, respectively. An abrupt change in instantaneous axis of rotation at terminal opposition was found. Ligament modelling shows dorsoradial ligament becomes tauter towards terminal opposition, whereas anterior oblique ligament becomes more slack. These results support the existence of the 'screw-home' pivot at terminal opposition and the importance of the dorsoradial ligament for stability in this position. The normal reference set in this study can help establish a diagnostic tool for subtle carpometacarpal instability, or for evaluating efficacy of surgery.

KEYWORDS:

Four-dimensional computed tomography; anterior oblique ligament; dorsoradial ligament; kinematics; trapeziometacarpal joint

PMID:
30068246
DOI:
10.1177/1753193418789828
[Indexed for MEDLINE]

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