An in vitro analysis of ligament reconstruction or extension osteotomy on trapeziometacarpal joint stability and contact area

The Journal of Hand Surgery
Matthew F KoffR J Strauch

Abstract

Painful instability of the minimally osteoarthritic thumb carpometacarpal (CMC) joint can be treated successfully by either ligament reconstruction or metacarpal extension osteotomy. The purpose of this study was to measure the laxity of cadaveric thumb CMC joints and to determine the influence of ligament reconstruction and metacarpal osteotomy on joint laxity and contact area. The baseline laxity of CMC joints from 25 fresh-frozen human cadaveric specimens (average age, 42 y; range, 18-55 y) was measured in the position of lateral pinch on a custom-designed CMC joint laxity tester. Joint laxity was measured again after 2 surgical simulations consisting of either a metacarpal extension osteotomy (at 10 degrees and 15 degrees) or a simulated Eaton-Littler ligament reconstruction (including total, volar, and dorsal ligament reconstructions relative to the plane of the thumbnail). Contact area between the thumb metacarpal and trapezium during testing was determined using stereophotogrammetry. The 15 degrees extension osteotomy significantly reduced CMC joint laxity in the radial-ulnar, dorsal-volar, pronation-supination, and distraction directions in the position of lateral pinch. The 10 degrees osteotomy reduced laxity only in t...Continue Reading

References

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Citations

Mar 5, 2013·Clinical Orthopaedics and Related Research·James D LinRobert J Strauch
Apr 1, 2014·BioMed Research International·Li-Chieh KuoFong-Chin Su
Nov 22, 2014·Hand : Official Journal of the American Association for Hand Surgery·Franklin H ChouRobert J Goitz
Nov 6, 2012·The Journal of Hand Surgery·Jason P WeberNeal C Chen
May 17, 2011·The Journal of Hand Surgery·Matthew M Tomaino
Aug 24, 2011·The Journal of Hand Surgery, European Volume·J F GoubauB Berghs
Mar 5, 2008·The Journal of the American Academy of Orthopaedic Surgeons·Ann E Van Heest, Patricia Kallemeier
Jul 17, 2021·The Journal of the American Academy of Orthopaedic Surgeons·Remy V RabinovichSteven Beldner

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