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Trapeziometacarpal osteoarthritis (TMC OA) is, also known as osteoarthritis at the base of the thumb, thumb carpometacarpal osteoarthritis, basilar (or basal) joint arthritis, or as rhizarthrosis. [ 3 ] [ 1 ] [ 2 ] This joint is formed by the trapezium bone of the wrist and the metacarpal bone of the thumb.
It presents on its base one facet on its superior surface, which is concavo-convex and articulates with the hamate, and one on its radial side, which articulates with the fourth metacarpal. On its ulnar side is a prominent tubercle for the insertion of the tendon of the extensor carpi ulnaris muscle .
The neck of a metacarpal is a common location for a boxer's fracture, but all parts of the metacarpal bone (including head, body and base) are susceptible to fracture. During their lifetime, 2.5% of individuals will experience at least one metacarpal fracture. Bennett's fracture (base of the thumb) is the most common. [4]
[1] [2] If sharp pain occurs along the distal radius (top of the forearm, about an inch below the wrist), de Quervain syndrome is likely. While a positive Finkelstein test is often considered pathognomonic for de Quervain syndrome, the maneuver can also cause some pain in those with osteoarthritis at the base of the thumb. [2]
The first dorsal interosseous, the most consistent, is inserted entirely into the base of its proximal phalanx and the extensor hood there. The second, third, and fourth dorsal interossei have insertions both proximally on the base of the metacarpal and hood, and distally on the lateral bands and central tendon of the extensor mechanism.
A boxer's fracture is the break of the fifth metacarpal bone of the hand near the knuckle. [4] Occasionally, it is used to refer to fractures of the fourth metacarpal as well. [1] Symptoms include pain and a depressed knuckle. [2] Classically, it occurs after a person hits an object with a closed fist. [3]
The Bennett fracture is an oblique intraarticular metacarpal fracture dislocation, caused by an axial force directed against the partially flexed metacarpal. This type of compression along the metacarpal bone is often sustained when a person punches a hard object, such as the skull or tibia of an opponent, or a wall. It can also occur as a ...
The base is small and quadrilateral; its superior surface presents two facets, a large one medially for articulation with the hamate, and a small one laterally for the capitate. On the radial side are two oval facets, for articulation with the third metacarpal; and on the ulnar side a single concave facet, for the fifth metacarpal.