Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Hand 89 articles


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 Débridement 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.

Trapeziometacarpal Joint Stability: The Evolving Importance of the Dorsal Ligaments

James D. Lin MD, MS, John W. Karl MD, MPH, Robert J. Strauch MD

Trapeziometacarpal (TMC) arthritis of the thumb is a common source of hand pain and disability. TMC ligamentous instability may play a role in TMC degeneration. However, the relative importance of the TMC ligaments in the etiology of degeneration and the use of surgery to treat instability in early-stage arthritis are unclear.

Coexisting Intraarticular Disorders Are Unrelated To Outcomes After Arthroscopic Resection of Dorsal Wrist Ganglions

Ho Jung Kang MD, PhD, Il Hyun Koh MD, Ji Sub Kim MD, Yun Rak Choi MD, PhD

Dorsal wrist ganglions are one of the most frequently encountered problems of the wrist and often are associated with intraarticular disorders. However, it is unclear whether coexisting intraarticular disorders influence persistent pain or recurrence after arthroscopic resection of dorsal wrist ganglions.

Comparative Responsiveness and Minimal Clinically Important Differences for Idiopathic Ulnar Impaction Syndrome

Jae Kwang Kim MD, PhD, Eun Soo Park MD

Patient-reported questionnaires have been widely used to predict symptom severity and functional disability in musculoskeletal disease. Importantly, questionnaires can detect clinical changes in patients; however, this impact has not been determined for ulnar impaction syndrome.

Outcomes After Volar Plate Fixation of Low-grade Open and Closed Distal Radius Fractures Are Similar

Jae Kwang Kim MD, PhD, Sang Doo Park MD

Low-grade (Gustilo and Anderson Type I or II) open distal radius fractures (DRFs) have been treated by volar locking plate fixation. However, it is unclear whether the outcomes after volar locking plate fixation for low-grade open DRFs are comparable to those for closed DRFs.

Is Diagrammatic Goniometry Feasible for Finger ROM Evaluation and Self-evaluation?

Valdas Macionis MD

While “diagrammatic” evaluation of finger joint angles using two folded paper strips as goniometric arms has been proposed and could be an alternative to standard goniometry and a means for self-evaluation, the measurement differences and reliability are unknown.

Distal Radius Malunion Increases Risk of Persistent Disability 2 Years After Fracture: A Prospective Cohort Study

Elisabeth Brogren MD, Philippe Wagner MSc, Michael Petranek MD, Isam Atroshi MD, PhD

Studies concerning the relationship between distal radius fracture malunion and a persistent arm-related disability have produced conflicting results.