The trapeziometacarpal screw home torque mechanism as a clinical indicator of the posterior joint ligament complex integrity: A cadaveric investigation

• Published in: Journal of hand therapy 2024-07, Vol.37 (3), p.388-396
• Main Authors: Normand, Mirka, Ibrahim, Mariam, Morsy, Mohamed, Brismée, Jean-Michel, Sobczak, Stéphane
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Bone Screws; Cadaver; Cadavers; Carpometacarpal Joints - diagnostic imaging; Carpometacarpal Joints - physiopathology; Cross-Sectional Studies; Degeneration; Digital imaging; Dorsal central ligament; Dorsal radial ligament; Dorsal subluxation; Female; Fingers & toes; Humans; Integrity; Investigations; Joints (anatomy); Ligaments; Ligaments, Articular - diagnostic imaging; Ligaments, Articular - injuries; Male; Measurement techniques; Middle Aged; Older people; Osteoarthritis; Osteoarthritis - diagnostic imaging; Osteoarthritis - physiopathology; Population studies; Posterior ligament complex; Posterior oblique ligament; Range of motion; Range of Motion, Articular - physiology; Screw home torque mechanism; Software; Statistical analysis; Statistical correlation; Therapists; Torque; Trapeziometacarpal osteoarthritis; Trapezium Bone - diagnostic imaging
• ISSN: 0894-1130; 1545-004X; 1545-004X
• DOI: 10.1016/j.jht.2023.08.007

To date, no clinical test provides specific objective information on the integrity of key ligamentous support of the trapeziometacarpal (TMC) joint. To examine the potential of the TMC joint screw home torque mechanism (SHTM) in estimating the integrity of the posterior ligament complex in older adult population. Cross-sectional laboratory-based study. Twenty cadaver hands presenting with various degrees of TMC joint degradation ranging from none to severe osteoarthritis (OA) were radiographed in multiple positions to establish their degeneration status, joint mobility, and amount of dorsal subluxation at rest and with the application of the SHTM. Comparisons and correlations between degeneration status, joint mobility, subluxation reduction and ligament status obtained from dissection were calculated. No significant statistical correlation was demonstrated with the subluxation reduction ratio of the SHTM and the combined ligament complex value however, a moderate negative correlation was found with dorsal central ligament injury at 21 Nm (τb = −0.46, p