Département d'Anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada; Chaire de Recherche en Anatomie Fonctionnelle, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada; Groupe de Recherche sur les Affections Neuromusculosquelettiques (GRAN), Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada; Rehabilitation Department, Pequot Health Center, Yale New Haven Health System, Groton, CT, USA.
Department of Rehabilitation Sciences and Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Orthopedic and Trauma Surgery Department, Assiut University, Asyut, Egypt.
J Hand Ther. 2024 Jul-Sep;37(3):388-396. doi: 10.1016/j.jht.2023.08.007. Epub 2023 Oct 2.
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. STUDY DESIGN: 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 < 0.05) and 34 Nm (τb = -0.45, p < 0.05). A statistically significant reduction of radial subluxation of the TMC joint was observed between the subluxation at rest (M = 5.2, SD = 1.9) and subluxation with SHTM of 21 Nm (M = 4.4, SD = 2.4), t (19) = 3.2, p = 0.01, 95% CI [0.3, 1.4] and subluxation with SHTM of 34 Nm (M = 4.3, SD = 2.6), t (19) = 2.6, p = 0.02, 95% CI [0.2, 1.5].
Our results did not support the SHTM as indicator of the TMC posterior ligament complex integrity however, it demonstrated 100% stabilization effect with non-arthritic TMC population.
迄今为止，尚无临床检查能够提供有关 trapeziometacarpal（TMC）关节关键韧带支撑完整性的具体客观信息。
研究 TMC 关节螺钉归位扭矩机制（SHTM）在评估老年人群中后韧带复合体完整性方面的潜力。
横断面实验室基础研究。
对 20 例具有不同程度 TMC 关节退变的尸体手进行 X 线摄影，以确定其退变程度、关节活动度以及在 SHTM 应用时休息和背侧半脱位的程度。对 SHTM 的半脱位减少率与从解剖学获得的退行性状态、关节活动度、半脱位减少和韧带状态之间的比较和相关性进行了计算。
未发现 SHTM 的半脱位减少率与综合韧带复合体值之间存在显著的统计学相关性，但在 21Nm（τb=-0.46，p<0.05）和 34Nm（τb=-0.45，p<0.05）时与背侧中央韧带损伤呈中度负相关。TMC 关节的桡侧半脱位明显减少，在休息时的半脱位（M=5.2，SD=1.9）和 SHTM 为 21Nm 时的半脱位（M=4.4，SD=2.4）之间（t（19）=3.2，p=0.01，95%置信区间[0.3，1.4]）和 SHTM 为 34Nm 时的半脱位（M=4.3，SD=2.6）（t（19）=2.6，p=0.02，95%置信区间[0.2，1.5]）。
我们的结果不支持 SHTM 作为 TMC 后韧带复合体完整性的指标，但它在非关节炎 TMC 人群中表现出 100%的稳定效果。
