The Thumb pp 11-23 | Cite as

Anatomy and Biomechanics

  • Young Keun Lee


The thumb is smaller and thicker than the other fingers but has always been represented as the pillar of the hand. The human thumb has evolved in the direction of increasing mobility and strength, although the stability is relatively lost in the evolutionary process. Thus, by performing the unique function of the thumb such as prehension, opposition, and circumduction, the hand enables not only fine and delicate tasks but also gross and powerful movements. This unique function of the thumb is partly due to the special arrangement of its bony column and associated muscles. Therefore, an accurate and comprehensive understanding of the anatomical features and biomechanics of the thumb provides a more accurate understanding of the diseases and traumas that occur on the thumb and will help hand surgeons to do more effective treatment.


Thumb Anatomy 


  1. 1.
    Chow SP. Digital nerves in the terminal phalangeal region of the thumb. Hand. 1980;12(2):193–6.CrossRefGoogle Scholar
  2. 2.
    Earley MJ. The arterial supply of the thumb, first web and index finger and its surgical application. J Hand Surg Br. 1986;11(2):163–74.CrossRefGoogle Scholar
  3. 3.
    Brunelli F, Gilbert A. Vascularization of the thumb. Anatomy and surgical applications. Hand Clin. 2001;17(1):123–38.PubMedGoogle Scholar
  4. 4.
    Ikeda A, Ugawa A, Kazihara Y, Hamada N. Arterial patterns in the hand based on a three-dimensional analysis of 220 cadaver hands. J Hand Surg Am. 1988;13(4):501–9.CrossRefGoogle Scholar
  5. 5.
    Parks BJ, Arbelaez J, Horner RL. Medical and surgical importance of the arterial blood supply of the thumb. J Hand Surg Am. 1978;3(4):383–5.CrossRefGoogle Scholar
  6. 6.
    Schmidt HM, Lanz U. Thumb. In: Surgical anatomy of the hand. Stuttgart: Georg Thieme Verlag; 2004. p. 85–113.Google Scholar
  7. 7.
    Pistre V, Pelissier P, Martin D, Baudet J. Vascular blood supply of the dorsal side of the thumb, first web and index finger: anatomical study. J Hand Surg Br. 2001;26(2):98–104.CrossRefGoogle Scholar
  8. 8.
    Ross AC. In: Standring S, editor. Wrist and hand. Gray’s anatomy. 41st ed. Amsterdam: Elsevier; 2016. p. 862–894 e1.Google Scholar
  9. 9.
    McFadden D, Bracht MS. Sex and race differences in the relative lengths of metacarpals and metatarsals in human skeletons. Early Hum Dev. 2009;85(2):117–24.CrossRefGoogle Scholar
  10. 10.
    Bettinger PC, Berger RA. Functional ligamentous anatomy of the trapezium and trapeziometacarpal joint (gross and arthroscopic). Hand Clin. 2001;17(2):151–68.PubMedGoogle Scholar
  11. 11.
    Pieron. In: Tubina R, editor. The first carpometacarpal joint. The hand. Philadelphia: W. B. Saunders; 1981. p. 169–83.Google Scholar
  12. 12.
    Barmakian JT. Anatomy of the joints of the thumb. Hand Clin. 1992;8(4):683–91.PubMedGoogle Scholar
  13. 13.
    Leversedge FJ. Anatomy and pathomechanics of the thumb. Hand Clin. 2008;24(3):219–29.CrossRefGoogle Scholar
  14. 14.
    Frank WE, Dobyns J. Surgical pathology of collateral ligamentous injuries of the thumb. Clin Orthop Relat Res. 1972;83:102–14.CrossRefGoogle Scholar
  15. 15.
    Gibeault JD, Saba P, Hoenecke H, Graham A. The sesamoids of the metacarpo-phalangeal joint of the thumb: an anatomical and clinical study. J Hand Surg Br. 1989;14(2):244–7.CrossRefGoogle Scholar
  16. 16.
    Aubriot JH. The metacarpophalangeal joint of the thumb. In: Tubiana R, editor. The hand, vol. 1. Philadelphia: WB Saunders; 1981. p. 184–7.Google Scholar
  17. 17.
    Kapanji IA. Biomechanics of the interphalangeal joint of the thumb. In: Tubiana R, editor. The hand, vol. 1. Philadelphia: WB Saunders; 1981. p. 188–90.Google Scholar
  18. 18.
    Kapandji IA. Biomechanics of the thumb. In: Tubiana R, editor. The hand, vol. 1. Philadelphia: WB Saunders; 1981. p. 404–22.Google Scholar
  19. 19.
    Duncan SF, Saracevic CE, Kakinoki R. Biomechanics of the hand. Hand Clin. 2013;29(4):483–92.CrossRefGoogle Scholar
  20. 20.
    Gupta S, Michelsen-Jost H. Anatomy and function of the thenar muscles. Hand Clin. 2012;28(1):1–7.CrossRefGoogle Scholar
  21. 21.
    Doyle JR, Blythe WF. Anatomy of the flexor tendon sheath and pulleys of the thumb. J Hand Surg Am. 1977;2(2):149–51.CrossRefGoogle Scholar
  22. 22.
    Zissimos AG, Szabo RM, Yinger KE, Sharkey NA. Biomechanics of the thumb flexor pulley system. J Hand Surg Am. 1994;19(3):475–9.CrossRefGoogle Scholar
  23. 23.
    Esplin VS, Tencer AF, Hanel DP, Cosio MQ. Restoration of function of the thumb flexor apparatus requires repair of the oblique and one adjacent flexor tendon pulley. J Orthop Res. 1996;14(1):152–6.CrossRefGoogle Scholar
  24. 24.
    Zbrodowski A, Gajisin S, Bednarkiewicz M. Mesotendons of the flexor pollicis longus muscle. Acta Anat (Basel). 1994;151(2):131–7.CrossRefGoogle Scholar
  25. 25.
    Posner MA, Kapila D. Restoration of opposition. Hand Clin. 2012;28(1):27–44.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Young Keun Lee
    • 1
  1. 1.Department of Orthopaedic SurgeryResearch Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University HospitalJeonjuSouth Korea

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