Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hand 85 articles


Intra- and Interobserver Reliability of the Eaton Classification for Trapeziometacarpal Arthritis: A Systematic Review

Aaron J. Berger MD, PhD, Arash Momeni MD, Amy L. Ladd MD

Trapeziometacarpal, or thumb carpometacarpal (CMC), arthritis is a common problem with a variety of treatment options. Although widely used, the Eaton radiographic staging system for CMC arthritis is of questionable clinical utility, as disease severity does not predictably correlate with symptoms or treatment recommendations. A possible reason for this is that the classification itself may not be reliable, but the literature on this has not, to our knowledge, been systematically reviewed.

Factors Associated With Survey Response in Hand Surgery Research

Arjan G. J. Bot MD, Jade A. Anderson BS, Valentin Neuhaus MD, David Ring MD, PhD

A low response rate is believed to decrease the validity of survey studies. Factors associated with nonresponse to surveys are poorly characterized in orthopaedic research.

Ultrastructure and Innervation of Thumb Carpometacarpal Ligaments in Surgical Patients With Osteoarthritis

Nathalie Mobargha MD, Cassie Ludwig BS, Amy L. Ladd MD, Elisabet Hagert MD, PhD

The complex configuration of the thumb carpometacarpal (CMC-1) joint relies on musculotendinous and ligamentous support for precise circumduction. Ligament innervation contributes to joint stability and proprioception. Evidence suggests abnormal ligament innervation is associated with osteoarthritis (OA) in large joints; however, little is known about CMC-1 ligament innervation characteristics in patients with OA. We studied the dorsal radial ligament (DRL) and the anterior oblique ligament (AOL), ligaments with a reported divergent presence of mechanoreceptors in nonosteoarthritic joints.

In Vivo Pilot Study Evaluating the Thumb Carpometacarpal Joint During Circumduction

Akira Goto MD, Shuai Leng PhD, Kazuomi Sugamoto MD, William P. Cooney MD, Sanjeev Kakar MD, Kristin Zhao PhD

Analysis of arthrokinematics may have clinical use in the diagnosis of dynamic instability of the thumb and wrist. Recent technological advances allow noninvasive, high-resolution imaging of skeletal (thumb and carpal bones) structures during motion.

In Vivo Kinematics of the Thumb Carpometacarpal Joint During Three Isometric Functional Tasks

Eni Halilaj BA, Michael J. Rainbow PhD, Christopher Got MD, Joel B. Schwartz BS, Douglas C. Moore MS, Arnold-Peter C. Weiss MD, Amy L. Ladd MD, Joseph J. Crisco PhD

The thumb carpometacarpal (CMC) joint is often affected by osteoarthritis—a mechanically mediated disease. Pathomechanics of the CMC joint, however, are not thoroughly understood due to a paucity of in vivo data.

Efficacy of Combined Osteotomy and Ulnar Nerve Transposition for Cubitus Valgus With Ulnar Nerve Palsy in Adults

Ho Jung Kang MD, Il Hyun Koh MD, Yu Chul Jeong MD, Tae Hwan Yoon MD, Yun Rak Choi MD

Tardy ulnar nerve palsy is a common late complication of traumatic cubitus valgus deformity. Whether both problems can be corrected together, safely and effectively, in a single surgical procedure remains unknown.

Review of the Molecular Development of the Thumb: Digit Primera

Kerby C. Oberg MD, PhD

The thumb, or digit 1, is not a typical digit. In addition to its unusual mobility and function, its formation is also unusual. It is the last digit to form and the most commonly targeted when limb development is disrupted. The thumb domain is defined by the overlapping expression of HOXA13, TBX5, GLI3R, and HOXD13 and, importantly, by an absence of other distal HOXD transcription factors. This brief review, combining developmental biology and clinical genetics, discusses the current understanding of how the thumb domain is established.

Functional Task Kinematics of the Thumb Carpometacarpal Joint

Kali R. Luker MD, Arnel Aguinaldo ATC, MA, Deborah Kenney OTR, Katelyn Cahill-Rowley MS, Amy L. Ladd MD

Abnormal biomechanical loading has been identified as an associated risk factor of osteoarthritis in the wrist and hand. Empirical data to date are insufficient to describe the role of altered biomechanics in thumb carpometacarpal (CMC) arthritis.

Degenerative Change at the Pseudarthrosis After Trapeziectomy at 6-year Followup

Hatem M. Salem MRCS, Tim R. C. Davis FRCS

Simple trapeziectomy has a well-documented history of success for the management of osteoarthritis at the trapeziometacarpal joint. There is concern, however, that late-onset failure can occur as a result of the development of degenerative disease at the scaphoid-metacarpal pseudarthrosis.

Does Arthroscopic DĂ©bridement With or Without Interposition Material Address Carpometacarpal Arthritis?

Julie E. Adams MD

Thumb carpometacarpal (CMC) joint arthritis is a common problem in clinical practice with a variety of treatment options. Arthroscopic procedures can preserve all or part of the trapezium in the setting of treatment of basilar joint arthritis, and such procedures (even without stabilization or ligament reconstruction) have high reported success rates. However, little is documented about the limitations of these procedures in terms of patient selection, the optimal type of interposition, if any, and rehabilitation.