An x-ray yesterday revealed a fractured first metacarpal
bone and David O'Meara's stable jockey now plans to visit a hand specialist in Leeds on Friday in the hope of finding a speedy treatment for the injury.
First, amputation was at the proximal third of the first metacarpal bone.
Options for thumb reconstruction are limited when amputations are at the proximal third of the first metacarpal bone.
The Artelon CMC Spacer Anthro can be used in minimally invasive, arthroscopic procedures in which it is implanted in the joint between the first metacarpal
and the trapezium.
The Artelon(R) CMC Spacer Arthro was designed with the guidance and assistance of surgeons to allow minimally invasive, arthroscopic implantation in the joint between the first metacarpal
and the trapezium.
The break - at the base of the first metacarpal
bone - was discovered by X-rays.
The basal joint is comprised of the articulation between the trapezium and the first metacarpal base.
It is also known as the deep anterior oblique ligament or beak ligament, since it inserts at the first metacarpal volar tubercle, which is shaped like a beak (Fig.
8) It was postulated that this area was under direct compressive forces when the thumb was in palmar abduction and extension, due to the close proximity of the abductor pollicis longus (APL) tendon's insertion on the base of the first metacarpal.
Since the first metacarpal is dynamically tethered by the adductor pollicis, with continued dorsoradial subluxation of the TM joint, the thumb assumes an adducted posture.
Prerequisites include minimal skin scarring, mobility of the first metacarpal, and at least half of the proximal phalanx remaining.
A "cocked-hat flap," originally described by Gilles, (3,4) involves mobilization of local skin and subcutaneous tissue from the dorsum and lateral aspects of the remaining first metacarpal to cover up to one inch of iliac crest bone graft.