Acta Ortopédica Mexicana

Espinosa GA, Trujillo MA, Ramírez LG, Romo RR, Zárate RG
Arthroscopy of the trapeziometacarpal joint: Anatomical study on cadavers
Acta Ortop Mex 2008; 22 (6)

Language: Español
References: 12
Page: 402-404
PDF: 394.12 Kb.

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Introduction: Osteoarthritis of the trapeziometacarpal joint is one of the most common degenerative diseases of the hand for which a variety of surgical procedures have been developed. Arthroscopic techniques offer good results, although they have not been standardized. Objective: To identify the main anatomical structures in relation to arthroscopy portals from the trapeziometacarpal joint and to determine their security area. Material and methods: We conducted a transversal and descriptive study in which the anatomy was analyzed in seven cadaveric specimens. Fourteen thumbs were dissected after the arthroscopic portals were made. In all of the specimens the distance between the radial artery, the articular line and the arthroscopy portals was measured. Results: The radial artery was found dorsal to the Extensor Pollicis Longus (EPL), 4-5 mm proximal to the dorsal arthroscopic portal, 4-8 mm to the articular line and 8-11 mm to the Extensor Pollicis Brevis (EPB). In two cases sensitive branches of the radial nerve were found through the dorsal portal. Conclusion: The anatomical evaluation defined a secure area for the dorsal portal between the EPL and the EPB. The proximal radial zone to the EPL must be avoided so that the dorsal branch of the radial nerve is not damaged.

Key words: osteoarthritis, trapezio-metacarpal joint, hand, arthroplasty, evaluation, anatomy.


  1. Armstrong AL, Hunter JB, Davis TRC: The prevalence of degenerative arthritis of the base of the thumb in post menopausal women. J Hand Surg 1994; 19B: 340-1.

  2. Freedman DM, Eaton RG, Glickel SZ: Long term results of volar ligament reconstruction for symptomatic basal join laxity. J Hand Surg 2000; 25A: 297-304.

  3. Fulton DB, Stern PJ: Trapeziometacarpal arthrodesis in primary ostheoarthritis: a minimum two year follow up study. J Hand Surg 2001; 26A: 109-14.

  4. Scheker LR: Artroplastía de suspensión dinámica en la osteoartritis trapeciometacarpiana. Rev Iber Cir Mano 2000; 27: 19-30.

  5. Barron OA, Glickel SZ, Eaton RG: Basal joint artritis of the thumb. J Am Acad Orthop Surg 2000; 8: 314-23.

  6. Trumble TE, Rafijah G, Gilbert M, Allan CH, North E, Mc Callister WV: Thumb trapeziometacarpal joint artritis: Partial trapeziectomy with ligament reconstruction and interposition costochondral allograft. J Hand Surg 2000: 25A: 61-76.

  7. Bettinger PC, Linscheid RL, Berger RA, Cooney WP, An KN: An anatomic study of the stabilizing ligaments of the trapezium and trapeziometacarpal joint. J Hand Surg 1999; 24A: 786-98.

  8. Toshimitsu Momose, Yukio Nakatsuchi, Saturo Sayito, Matsumoto J: Contact area of the Trapeziometacarpal joint. J Hand Surg 1999; 24A: 491-5.

  9. Kubik NJ, Lubahn JD: Intrarater and interrater reliability of the Eaton classification of basal joint arthritis. J Hand Surg 2002; 27A: 882-5.

  10. Arnoczky SP, Aksan A: Thermal modification of connective Tissues: basic science considerations and clinical implications. J Am Acad Orthop Surg 2000; 8: 305-13.

  11. Menon J: Arthroscopic management of trapeziometacarpal joint arthritis of the thumb. Arthroscopy 1996; 12: 581-7.

  12. González MH, Kemmler J, Weinzweig N, Rinella A: Portals for arthroscopy of the trapeziometacarpal joint. J Hand Surg 1997; 22B: 574-5.