Abstract
Destabilization of the trapezium from its normal orientation with respect to the trapezoid,
second metacarpal, and thumb metacarpal leads to incongruity at the trapeziometacarpal
(TMC) joint. Abnormal shear forces may eventually result in TMC joint arthritis. By
determining the relative stiffness and strength of the ligaments that stabilize this
joint, one may infer their role in providing stability to the TMC joint. This study
addresses the material properties of the ligaments stabilizing the trapezium and TMC
joint to better understand the mechanics and kinematics of this joint. Fresh-frozen
cadaveric hands (10 males and 10 females) were used to obtain bone-ligament-bone complexes
from the dorsal and volar trapeziotrapezoid ligaments, dorsal and volar trapezio-second
metacarpal ligaments, anterior oblique ligament, dorsoradial ligament, and trapezio-third
metacarpal (T-III MC) ligament. The following material properties were derived from
our data: ultimate load, ultimate stress (normalized failure load), ultimate strain
(percent elongation), stiffness, toughness (energy to failure), and hysteresis. The
dorsoradial ligament demonstrated the greatest ultimate load and toughness (energy
to failure). The T-III MC ligament demonstrated the greatest ultimate stress (normalized
failure load) and stiffness. The anterior oblique ligament demonstrated the least
stiffness and the greatest hysteresis. The material properties of capsuloligamentous
structures may be a good indicator of their importance to joint stability. Using these
criteria we conclude that the T-III MC and dorsoradial ligaments are important stabilizers
of the trapezium and TMC joint, respectively. These two ligaments were found to be
the strongest, stiffest, and toughest ligaments, while the anterior oblique ligament
was relatively weak and compliant. The dorsal trapezio-second metacarpal, volar trapezio-second
metacarpal, and T-III MC ligaments were all relatively strong and are anatomically
aligned to function as tension bands to restrain the trapezium against cantilever
bending forces applied to it by the thumb during key or tip pinch. (J Hand Surg 2000;25A:1085-1095.
Copyright © 2000 by the American Society for Surgery of the Hand.)
Keywords
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Article info
Publication history
Accepted:
June 20,
2000
Received:
January 7,
2000
Footnotes
*Supported in part by the Riordan-Brand Research Grant.
**Although the author or authors have not received or will not receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article, benefits have been or will be received but are directed solely to a research fund, foundation, educational institution, or other non-profit organization with which one or more of the authors are associated.
★Reprint requests: Kai-Nan An, PhD, Orthopaedic Biomechanics Lab, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
Identification
Copyright
© 2000 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
