The Sensitivity of the Endpoint Forces of Thumb Extrinsic and Intrinsic Muscles to Changes in Joint Angles, Muscle Moment Arms and Bone Lengths in the Flexed Thumb.

Abstract

A previous study showed in situ measurements of thumb-tip forces produced by muscles vary substantially among cadaveric specimens. Potential sources of variability include inter-specimen anatomic differences and postural deviations from the nominal posture in which the specimens were tested. This study aimed to theoretically determine the variation in thumb-tip force caused by inter-specimen differences in thumb anatomy and posture. We developed a two-dimensional mathematical model of force production at the thumb tip based on published estimates of muscle moment arms, bone length, and joint angle measurements from nine cadaveric specimens. The model was placed in a flexed posture. Using the model, we calculated variations in magnitude and direction of each muscle's thumb-tip force induced by a ±1 standard deviation (or equivalent) variation in each bone length, the moment arm of the muscle (i.e., anatomic factors), and each joint angle (i.e., postural factor). For most muscles, inter-specimen differences in the metacarpophalangeal (MP) joint angle produced at least a 75% larger variation in thumb-tip force magnitude than that produced by other factors. For all muscles, differences in the interphalangeal joint angle among specimens produced the largest variation in thumb-tip force direction. For some muscles, inter-specimen differences in bone lengths, moment arms, and MP joint angles also produced large variations in thumb-tip force direction. This study suggests deviation from the nominal flexed thumb posture and large measurement variability in muscle moment arms are primary and secondary sources, respectively, of variability in thumb-tip forces produced by the majority of thumb muscles. Further, this study suggests a more careful approach to standardizing the thumb posture would likely improve current measurements of thumb-tip forces.Clinical Relevance- This work describes the influence of anatomic and postural factors on thumb-tip forces that thumb muscles produce. The results of this work have implications for musculoskeletal modeling and surgical reconstruction of grasp.