The Relationship Between Digit Independence and Digital Sesamoids in Humans and a Proposal of a New Digital Sesamoid Evolutionary Hypothesis
Authors: Yammine Kaissar 
Published: January 2018

Digital sesamoids are found in the metapodial‐phalangeal joints of most mammals and quadrupedal tetrapods, yet their functional significance is still unclear. During primate evolution, a slight decline in their frequency has been associated with brachiation in gibbons, followed by a quasi‐complete absence in orangutans then a slight resurgence occurred in gorillas and chimpanzees. Simultaneously, forearm muscles showed a progressive division in hominoid evolution towards a more “individualistic” musculature yielding more mobility and independence to some fingers. In humans, sesamoids are consistently observed in thumbs and big toes and frequently in other hypermobile digits such as the index and little fingers. Using a simple mathematical equation, this paper attempted to quantify a presumed association between hypermobile fingers and sesamoid frequency and distribution in humans. To this, an anatomic definition of digital independence has been formulated which includes three variables; (1) number and (2) frequency of independent flexor/extensor forearm muscles destined to a single finger, (3) and number of free/absent webspace. Results of previous meta‐analyses and means of big sample studies were used to evaluate the frequency of such muscles. The expected values obtained via this model were found to be very close to the observed (published) values of the ossified sesamoids in human hands, and that in terms of frequency and distribution. The findings in humans showed a quasi‐linear association between the degree of mobility and sesamoid frequency. The more the number of independent muscles destined to a finger, the more its metacarpo‐phalangeal joint is likely to bear sesamoids. Based on our results and on a new analysis of primates' forearm/hand muscles and sesamoid evolution, a new hypothesis is proposed to answer two questions; the evolution of digital sesamoid frequency in primates and its sesamoid distribution in human digits. It claims that the number/frequency of independent forearm/hand muscles, and particularly the independent extensors, is likely to be a major factor in sesamoid reversion in hominoids. The argument is based on the link between the metatarsal break induced by the digitigrade locomotion observed in quadrupedal mammals and tetrapods and the amount of extra‐extension of the metacarpo‐phalangeal joints conferred by the individualization of some forearm extensors. The same rationale yielded similar conclusions when applied to both the hand and foot. The manipulative function of the hand and the plantigrade locomotion of the foot required such extra‐extension in specific digits and consequently, a higher frequency of digital sesamoids was associated with these two different functions. The new evolutionary analysis suggests evolutionary pathways for both, the sesamoids of the hands and feet, and speculates that muscle individualization would have induced a very slow re‐acquisition of digital sesamoids when compared to their rapid decline after brachiation. It is the first hypothesis offering a plausible explication on the recent evolution of digital sesamoids; specifically, the progression of sesamoid frequency in African apes and its resurgence, prevalence and distribution in humans. Anat Rec, 301:1046–1060, 2018. © 2018 Wiley Periodicals, Inc.