Trapeziometacarpal joint loading during key pinch grip: A cadaver study

Abstract

To our knowledge, no study has directly measured the loads in the trapeziometacarpal joint during an isometric key pinch. The aim of this study was to measure the load acting on the trapeziometacarpal joint for increasingly greater key pinch forces (0.5 kg–1.5 kg). We performed a cadaver study using 10 fresh-frozen, unembalmed adult forearms and hands (5 right and 5 left). Thumb pinch was simulated by loading the main actuator tendons involved in the key pinch grip (i.e., adductor pollicis, flexor pollicis longus, extensor pollicis longus, extensor pollicis brevis and abductor pollicis longus tendons). Measurements were made inside the joint using a force-sensing resistor sensor (Tekscan® FlexiForce™ force sensor). All specimens were tested twice in a row in the same condition. The median load values recorded in the trapeziometacarpal joint were 1.9 kg (IQR 2.2–1.5), 3 kg (IQR 3.4–2.7) and 4.1 kg (IQR 4.4–3.9) during 0.5 kg, 1 kg, and 1.5 kg key pinch, respectively. For each specimen, similar load values were observed during both loading trials. Our findings indicate that the loads measured directly in the trapeziometacarpal joint during a simple key pinch are materially lower than those estimated in biomechanical models of the thumb (generally greater than 10 kg for 1 kg of applied force) probably due to intersubject variability. This pilot study will serve as a basis for further studies, for example, comparing biomechanical thumb models and experimental measurements under the same set-up conditions.