Purpose
The purpose of our study was to investigate, in a cadaver model, the effect of increasing
thumb metacarpophalangeal (MCP) joint hyperextension on thumb axial load and key pinch
force after thumb trapeziectomy and flexor carpi radialis suspensionplasty. We developed
a cadaveric model to test whether thumb MCP joint hyperextension after trapeziectomy
would have a negative effect on key pinch force and increase loads across a reconstructed
thumb carpometacarpal (CMC) joint.
Methods
We created a cadaveric biomechanical model that varied thumb MCP joint hyperextension
while measuring thumb CMC axial and key pinch force under standardized loads. Direct
observations were made of how key pinch and axial thumb CMC force change with increasing
thumb MCP joint hyperextension. We measured the thumb key pinch force and axial thumb
CMC joint load with the thumb MCP joint in 0°, 10°, 20°, 30°, 40°, 50°, and 60° of
hyperextension.
Results
There was a 0.88 N (2.4%) increase in axial force across the thumb CMC per every 10°
of increasing thumb MCP joint hyperextension. We found a 0.53 N (4.4%) reduction in
key pinch force for every 10° of increasing thumb MCP joint hyperextension. Therefore,
at 60° of thumb MCP joint hyperextension, the axial force across the thumb CMC increased
by 5.3 N (14.6%) and the key pinch force was weakened by 3.2 N (26.6%).
Conclusions
With progressive thumb MCP joint hyperextension after thumb CMC arthroplasty, we found
a decrease in key pinch force and an increase in axial thumb CMC joint force. The
decrease in key pinch force was larger than the relatively small increase in thumb
CMC force.
Clinical relevance
This study helps elucidate the biomechanics of the thumb CMC joint after resection
arthroplasty with thumb MCP joint hyperextension and helps understand the interplay
between these 2 conditions.
Key words
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Article info
Publication history
Published online: February 22, 2023
Accepted:
November 9,
2022
Received:
February 27,
2022
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
