title: Efficacy of Dorsoradial Capsulodesis for Trapeziometacarpal Joint Instability: A Cadaver Study.
abstract: OBJECTIVE
  To test the biomechanical properties of the dorsoradial capsulodesis procedure.
  
  
  METHODS
  Six cadaveric hands were used. After exposing the trapeziometacarpal (TMC) joint, we placed Kirschner wires in the distal radius and thumb metacarpal. The rotation shear test was then performed to test the joint axial laxity, and angular measurements using Kirschner wires as reference points were documented. The dorsoradial (DR) ligament and capsule were released, followed by the intermetacarpal (IM) ligament; angular measurements were obtained. Finally, the DR capsulodesis procedure was performed, and final measurements were obtained. Comparisons were made among the various stages of ligament integrity to determine the amount of stability provided by DR capsulodesis.
  
  
  RESULTS
  All cadavers demonstrated axial laxity with transection of the DR ligament; an increase in stability was obtained after DR capsulodesis. Transection of the capsule and IM ligament caused increased laxity relative to the native joint (median, 24° and 35°, respectively, on rotational testing). After we performed DR capsulodesis, rotational stability improved by a median of 41° compared with DR ligament transection, 49° compared with DR and IM ligament transection, and 18° relative to the native joint.
  
  
  CONCLUSIONS
  Dorsoradial capsulodesis restores rotational stability for TMC joint after division of the DR and IM ligaments. The stability achieved was statistically significant compared with both an intact native TMC joint and induced laxity of the TMC joint.
  
  
  CONCLUSIONS
  The DR capsulodesis procedure may improve rotational stability to the TMC joint.
authors.affiliation: Department of Orthopedic Surgery, College of Medicine, University of Oklahoma, Oklahoma City, OK.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Chenoweth
authors.affiliation: Department of Orthopedic Surgery, College of Medicine, University of Oklahoma, Oklahoma City, OK.
authors.forename: Gavin D
authors.initials: GD
authors.lastname: O'Mahony
authors.affiliation: University of Oklahoma Health Sciences Center, Oklahoma City, OK.
authors.forename: Casey
authors.initials: C
authors.lastname: Fitzgerald
authors.affiliation: Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma, Oklahoma City, OK.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Stoner
authors.affiliation: Department of Cell Biology, University of Oklahoma Health Sciences Center, University of Oklahoma, Oklahoma City, OK.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: O'Donoghue
authors.affiliation: Hand Surgery Division, INTEGRIS Baptist Medical Center, Oklahoma City, OK. Electronic address: Lora.Nall@IntegrisOK.com.
authors.forename: Ghazi M
authors.initials: GM
authors.lastname: Rayan
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D001864:Bone Wires; D002102:Cadaver; D052737:Carpometacarpal Joints / Q000502:physiology / Q000601:surgery*; D005260:Female; D006801:Humans; D017746:Joint Capsule / Q000601:surgery; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000502:physiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013933:Thumb / Q000502:physiology / Q000601:surgery*; D051222:Trapezium Bone / Q000502:physiology / Q000601:surgery*
keywords: Dorsoradial capsulodesis; joint instability; trapeziometacarpal joint