c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Metacarpotrapezial Osteoarthritis and Shepler Repair: 7

A D V E R T I S E M E N T

   
 

Dislocation/subluxation of the metacarpotrapezial joint leads to a compensatory "zig-zag" deformity.       

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Metacarpotrapezial Osteoarthritis and Shepler Repair: 8

A D V E R T I S E M E N T

   
 

When the distal side of the MC-T is subluxed dorsally, it does not have normal motion especially in extension. The MP joint may not only hyperextend but lose flexion. This ankylosis leaves the thumb locked in the palm in a rigid, dysfunctional position. This resulting "swan-neck" posture consists of hyperextension of the MP joint and DIP joint flexion.      

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Metacarpotrapezial Osteoarthritis and Shepler Repair: 9

A D V E R T I S E M E N T

   
 

Obtaining a clear X-ray of all four trapezial articulations requires some awkward positioning. To get in this position, the index finger pinches the tip of the thumb, the wrist is flexed, the elbow is flexed to 90 degreees, and the resulting surface (dorsal thumb, radial index finger, radial side of the forearm, lateral side of the humerus, and shoulder) is laid on a radiographic table, with the hand and thumb positioned on an x-ray cassette. In this position, the thumb should be parallel to the humerus.     

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This page was last modified on 4/1/1999.