Surgical Treatments for Scapholunate Advanced Collapse Wrist: Kinematics and Functional Performance

Wolff, Aviva L.; Garg, Rohit; Kraszewski, Andrew P.; Hillstrom, Howard J.; Hafer, Jocelyn F.; Backus, Sherry I.; Lenhoff, Mark; Wolfe, Scott W.

doi:10.1016/j.jhsa.2015.04.035

Cited by 28 publications

(11 citation statements)

References 24 publications

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“…Recently, several investigative groups have applied dynamic motion measurement techniques to assess wrist injury and arthritis. Wolff et al (2015) quantified the dart thrower’s plane of coupled motion during functional activities using 3DMA in individuals who have undergone 4CF and PRC, compared with healthy individuals. Differences in wrist kinematics and performance were identified between the groups.…”

Section: Functional Kinematics Of the Wristmentioning

confidence: 99%

Functional kinematics of the wrist

Rainbow

Wolff

Crisco

et al. 2015

J Hand Surg Eur Vol

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The purpose of this article is to review past and present concepts concerning functional kinematics of the healthy and injured wrist. To provide a context for students of the wrist, we describe the progression of techniques for measuring carpal kinematics over the past century and discuss how this has influenced today's understanding of functional kinematics. Next, we provide an overview of recent developments and highlight the clinical relevance of these findings. We use these findings and recent evidence that supports the importance of coupled motion in early rehabilitation of radiocarpal injuries to develop the argument that coupled motion during functional activities is a clinically relevant outcome; therefore, clinicians should develop a framework for its dynamic assessment. This should enable a tailored and individualized approach to the treatment of carpal injuries.

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Section: Functional Kinematics Of the Wristmentioning

confidence: 99%

Functional kinematics of the wrist

Rainbow

Wolff

Crisco

et al. 2015

J Hand Surg Eur Vol

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“…1, inset). While effective at reducing pain, these surgeries degrade kinematic motion at the wrist and also impair functional performance at the hand (Wolff et al 2015). Loss of grip and pinch strength, in particular, are widely reported as debilitating functional impairments (Nagelvoort et al 2002; Bain and Watts 2010; Richou et al 2010).…”

Section: Introductionmentioning

confidence: 99%

Connecting the wrist to the hand: A simulation study exploring changes in thumb-tip endpoint force following wrist surgery

Nichols

Bednar

Wohlman

et al. 2017

Journal of Biomechanics

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The wrist is essential for hand function. Yet, due to the complexity of the wrist and hand, studies often examine their biomechanical features in isolation. This approach is insufficient for understanding links between orthopaedic surgery at the wrist and concomitant functional impairments at the hand. We hypothesize that clinical reports of reduced force production by the hand following wrist surgeries can be explained by the surgically-induced, biomechanical changes to the system, even when those changes are isolated to the wrist. This study develops dynamic simulations of lateral pinch force following two common surgeries for wrist osteoarthritis: scaphoid-excision four-corner fusion (SE4CF) and proximal row carpectomy (PRC). Simulations of lateral pinch force production in the nonimpaired, SE4CF, and PRC conditions were developed by adapting published models of the nonimpaired wrist and thumb. Our simulations and biomechanical analyses demonstrate how the increased torque-generating requirements at the wrist imposed by the orthopaedic surgeries influence force production to such an extent that changes in motor control strategy are required to generate well-directed thumb-tip end-point forces. The novel implications of our work include identifying the need for surgeries that optimize the configuration of wrist axes of rotation, rehabilitation strategies that improve post-operative wrist strength, and scientific evaluation of motor control strategies following surgery. Our simulations of SE4CF and PRC replicate surgically-imposed decreases in pinch strength, and also identify the wrist's torque-generating capacity and the adaptability of muscle coordination patterns as key research areas to improve post-operative hand function.

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“…For all studies, the skew orientation of the nonimpaired axes is farther from orthogonal than 92.6° and 99.8°, the skew orientations reported for 4CF and SE4CF, respectively (Table 2). A recent in vivo study by Wolff et al 26 also demonstrates that when compared to healthy controls, kinematic coupling is significantly reduced in SE4CF patients. This conclusion is congruent with the results of this study; a reduction in kinematic coupling is consistent with a reduction in the skew orientation of the axes of rotation.…”

Section: Discussionmentioning

confidence: 92%

Decoupling the Wrist: A Cadaveric Experiment Examining Wrist Kinematics Following Midcarpal Fusion and Scaphoid Excision

Nichols¹,

Bednar

Havey

et al. 2017

Journal of Applied Biomechanics

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At the wrist, kinematic coupling (the relationship between flexion-extension and radial-ulnar deviation) facilitates function. Although the midcarpal joint is critical for kinematic coupling, many surgeries, such as four-corner fusion (4CF) and scaphoid-excision four-corner fusion (SE4CF), modify the midcarpal joint. This study examines how 4CF and SE4CF influence kinematic coupling by quantifying wrist axes of rotation. Wrist axes of rotation were quantified in eight cadaveric specimens using an optimization algorithm, which fit a two-revolute joint model to experimental data. In each specimen, data measuring the motion of the third metacarpal relative to the radius was collected for three conditions (nonimpaired, 4CF, SE4CF). The calculated axes of rotation were compared using spherical statistics. The angle between the axes of rotation was used to assess coupling, as the nonimpaired wrist has skew axes (i.e., angle between axes approximately 60°). Following 4CF and SE4CF, the axes are closer to orthogonal than those of the nonimpaired wrist. The mean angle (±95 percent confidence interval) between the axes was 92.6° ± 25.2° and 99.8° ± 22.0° for 4CF and SE4CF, respectively. The axes of rotation defined in this study can be used to define joint models, which will facilitate more accurate computational and experimental studies of these procedures.

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Surgical Treatments for Scapholunate Advanced Collapse Wrist: Kinematics and Functional Performance

Cited by 28 publications

References 24 publications

Functional kinematics of the wrist

Functional kinematics of the wrist

Connecting the wrist to the hand: A simulation study exploring changes in thumb-tip endpoint force following wrist surgery

Decoupling the Wrist: A Cadaveric Experiment Examining Wrist Kinematics Following Midcarpal Fusion and Scaphoid Excision

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