Abstract
BackgroundThumb opposition is vital for hand function and involves pronation and palmar abduction. The improvement of pronation is often used as one of the evaluation items of the opponensplasty method for severe carpal tunnel syndrome. However, most of the studies used substitution evaluation methods for measurement of the pronation angle. Thus, there is still no appropriate method for measuring thumb pronation angle accurately in carpal tunnel syndrome patients.In recent reports, a wearable gyroscope was used to evaluate upper extremity motions and it can be possibly used for accurate measurement of the thumb pronation angle along the three-dimensionally moving bone axis.Thus, we investigated the reliability of measuring thumb pronation using a gyroscope and evaluated whether this method can be used to detect opposition impairment.MethodsThe participants were volunteers with unaffected upper limbs (32 hands) and patients with carpal tunnel syndrome (27 hands). The pronation and palmar abduction angles during opposition movements were measured using a three-axis gyroscope that included a three-axis accelerometer. The gyroscope was fixed onto the first metacarpal bone and the thumb phalanx.ResultsThe pronation and palmar abduction angles of the metacarpal bone and the palmar abduction angles of the phalanx significantly decreased in the carpal tunnel syndrome group. The pronation angle of the metacarpal bone during opposition movement peaked later than the palmar abduction angle in all hands.ConclusionsWe were able to measure the thumb pronation and palmar abduction angles using the three-axis gyroscope, and this tool was able to detect impairments of thumb opposition due to carpal tunnel syndrome. This could be a tool for measuring thumb and finger angles and for detecting impairments caused by various diseases.
Highlights
Thumb opposition is vital for hand function and involves pronation and palmar abduction
First, we investigated the reliability of measuring the thumb pronation and palmar abduction angles using a small sensor with a three-axis gyroscope and accelerometer
We considered that the researchers only evaluated the thumb pronation, which was projected into two dimensions using Computed tomography (CT) imaging; the thumb pronation angle was overestimated as Control (n = 32) Carpal tunnel syndrome (CTS) (n = 27) P value coefficient of variation (CV)
Summary
Thumb opposition is vital for hand function and involves pronation and palmar abduction. There is still no appropriate method for measuring thumb pronation angle accurately in carpal tunnel syndrome patients. Opposition movement plays a key role in hand motions such as pulp pinch, grip, and Kuroiwa et al Journal of Orthopaedic Surgery and Research (2018) 13:288 these reports, nail tip angle, spatial angle, or Kapandji score were used in the substitution evaluation method for the measurement of the pronation angle. These methods can be adapted longitudinal evaluation of a single patient; they have a number of shortcomings. Despite the decrease in the pronation of the thumb in CTS patients in actual clinical practice, the lack of an appropriate assessment method to evaluate the patients’ function remains
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