Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

Featured on Channel NewsAsia

PASSIVE TEST FOR THE TRAPEZIUM-FIRST METACARPAL JOINT

Backwards movement during
extension

Positioning.

The subject stands with the arm hanging and the elbow bent to 90° and in supination.The examiner faces the subject. One hand grasps the hand and stabilizes it.

Procedure.

The other hand moves the thumb into extension first and then backwards.

Common mistakes.

The thumb is hyperextended in the metacarpophalangeal joint, so that most
stress falls on this joint and not on the trapezium- first metacarpal one.

Normal functional anatomy:

• Rmlge: until the movement stops
• Elld-feel: elastic
• Lill/itillg structures: stretching of the anterolateral part of the joint capsule of the
trapezium-first metacarpal joint.

Common pathological situations:

• Pain indicates arthritis or arthrosis (‘rhizarthrosis’) generally of the joint between
the trapezium and the first metacarpal bones.
More exceptionaUy it is the joint between trapezium and scaphoid bones.
• Excessive range of motion occurs after rupture of the ulnar aspect of the
metacarpophalangeal joint capsule.

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