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The Archives of Bone and Joint Surgery، جلد ۶، شماره ۲، صفحات ۰-۰
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عنوان انگلیسی The Stabilising Effect of the Anterior Oblique Ligament to Prevent Directional Subluxation at the Trapeziometacarpal Joint of the Thumb: A Biomechanical Cadaveric Study
چکیده انگلیسی مقاله Introduction The trapeziometacarpal joint is inherently unstable, relying on ligament restraint to prevent subluxation. Subluxation of the thumb in a dorsoradial direction is often observed in clinical practice, either after acute ligament injury or more commonly with osteoarthritis (OA). This subluxation follows loss of function of trapeziometacarpal ligaments that stabilise this joint, resisting the deforming force of abductor pollicis longus (APL). The exact ligaments that stabilise and prevent the thumb from the pull of APL causing dorsoradial subluxation remain unknown, although the anterior oblique ligament (AOL) has been implicated. The aim of this study was to measure the direction of subluxation resisted by the AOL. Method In this study we used cadaveric limbs and custom made biomechanical testing to measure the influence AOL has in stabilising the thumb against subluxation in three planes: radial, dorsal and dorsoradial. Three fresh frozen hands were dissected to expose the trapeziometacarpal joint (TMCJ), leaving all ligaments, capsule and APL attachment in place. The force required to create a displacement of 0.5mm between the first metacarpal and the trapezium in these three planes was measured before and after AOL division. Results The average force to displace in the dorsoradial plane prior to division was 6.68N, and a statistically significant reduction to 1.15N (p< 0.001) was found after division of the AOL. A statistically significant increase in force (p< 0.001) from 2.89N to 4.04N was seen in the radial plane, while no change was seen dorsally (p=0.98), with average forces of 2.74N and 2.62N found pre and post division. Discussion There is clinical significance in reporting quantifiable data in this field, as subluxation of the thumb is often seen with OA. The results of our study provide support for surgical reconstruction of the AOL as the primary surgical stabilizer against dorsoradial subluxation of the thumb
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نویسندگان مقاله مارک r mccann | mark r mccann
department of anatomy, edinburgh university medical school, uk


philippa a rust | philippa a rust
hand surgery unit, st john’s hospital, livingston, uk


رابرت wallace | robert wallace
department of orthopaedics, university of edinburgh, uk
نشانی اینترنتی http://abjs.mums.ac.ir/article_10307.html
فایل مقاله اشکال در دسترسی به فایل - ./files/site1/rds_journals/328/article-328-574375.pdf
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زبان مقاله منتشر شده en
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نوع مقاله منتشر شده RESEARCH PAPER
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