scholarly journals Carpal Pronation and Supination Changes in the Unstable Wrist

2018 ◽  
Vol 07 (04) ◽  
pp. 298-302
Author(s):  
Walter Short ◽  
Frederick Werner
Keyword(s):  
Clinical Relevance ◽  
Wrist Flexion ◽  
New Techniques ◽  
Interosseous Ligament ◽  
Wrist Motion ◽  
Extensor Carpi Ulnaris ◽  
Flexion Extension ◽  
Before And After ◽  
Dart Throwing ◽  
Throwing Motion

Background Little is known about changes in scaphoid and lunate supination and pronation following scapholunate interosseous ligament (SLIL) injury. Information on these changes may help explain why some SLIL reconstructions have failed and help in the development of new techniques. Purpose To determine if following simulated SLIL injury there was an increase in scaphoid pronation and lunate supination and to determine if concurrently there was an increase in the extensor carpi ulnaris (ECU) force. Materials and Methods Scaphoid and lunate motion were measured before and after sectioning of the SLIL and two volar ligaments in 22 cadaver wrists, and before and after sectioning of the SLIL and two dorsal ligaments in 15 additional wrists. Each wrist was dynamically moved through wrist flexion/extension, radioulnar deviation, and a dart-throwing motion. Changes in the ECU force were recorded during each wrist motion. Results Scaphoid pronation and lunate supination significantly increased following ligamentous sectioning during each motion. There were significant differences in the amount of change in lunate motion, but not in scaphoid motion, between the two groups of sectioned ligaments. Greater percentage ECU force was required following ligamentous sectioning to achieve the same wrist motions. Conclusion Carpal supination/pronation changed with simulated damage to the scapholunate stabilizers. This may be associated with the required increases in the ECU force. Clinical Relevance In reconstructing the SLIL, one should be aware of the possible need to correct scaphoid pronation and lunate supination that occur following injury. This may be more of a concern when the dorsal stabilizers are injured.

scholarly journals Biomechanical Comparison of Dart-Throw Motions after Partial Wrist Fusions

2021 ◽  
Author(s):  
Dami O. Oluyede ◽  
Frederick W. Werner ◽  
Garrett Esper ◽  
Michael Schreck
Keyword(s):  
Range Of Motion ◽  
Limited Information ◽  
Wrist Motion ◽  
Flexion Extension ◽  
Dart Throwing ◽  
Fresh Frozen ◽  
Biomechanical Comparison ◽  
Other Orientation ◽  
Comprehensive Compilation ◽  
Throwing Motion

Abstract Background Multiple partial wrist fusions exist for the management of arthritic disease. Limited information is available on their effect on wrist range of motion in the dart-throwing direction of wrist motion, even though it is used in most activities of daily living. Purpose The purpose of this study was to measure the retained motion for different orientations of dart-throwing motion for seven different partial wrist fusions and proximal row carpectomy (PRC). Methods Eight fresh frozen right cadavers were tested with the wrist intact and followed simulated fusions. Fusions were performed using an external fixation technique and included scaphocapitate, scapholunate (SL), capitolunate, radiolunate, radioscapholunate, scaphotrapeziotrapezoid, 4 corner fusion, and PRC. Results In the intact wrist, the average arc of wrist motion with the wrist oriented at 20 degrees away from the flexion-extension axis was significantly larger than at any other orientation of motion. All partial wrist fusions and the PRC had significantly smaller average dart-throw arc of motion compared with intact at an orientation 20 and 25 degrees away from flexion-extension. The SL fusion provided a significantly larger arc of motion than most of the other fusions at most orientations. Conclusion/Clinical Relevance This study provides a comprehensive compilation of the range of motion in a functional plane, “the dart-throw motion,” for limited wrist fusions and PRC. These data provide the clinician with important information that can be used to educate patients regarding expectations after surgery.

scholarly journals Kinematic analysis of two scapholunate ligament reconstruction techniques

2021 ◽  
Vol 29 (2) ◽  
pp. 230949902110258
Author(s):  
Seungbum Chae ◽  
Junho Nam ◽  
Il-Jung Park ◽  
Steven S. Shin ◽  
Michelle H. McGarry ◽  
...  
Keyword(s):  
Kinematic Analysis ◽  
Clinical Relevance ◽  
Ligament Reconstruction ◽  
Operative Time ◽  
Efficient Technique ◽  
Scapholunate Ligament ◽  
Interosseous Ligament ◽  
Flexion Extension

Purpose: This study compares the kinematic changes after the procedures for scapholunate interosseous ligament (SLIL) reconstruction—the modified Brunelli technique (MBT) and Mark Henry’s technique (MHT). Methods: Ten cadaveric wrists were used. The scapholunate (SL) interval and angle and radiolunate (RL) angle were recorded using the MicroScribe system. The SL interval was measured by dividing the volar and dorsal portions. Four motions of the wrist were performed—neutral, flexion, extension, and clenched fist (CF) positions—and compared among five conditions: (1) intact wrist, (2) volar SLIL resection, (3) whole SLIL resection, (4) MBT reconstruction, and (5) MHT reconstruction. Results: Under the whole SLIL resection condition, the dorsal SL intervals were widened in all positions. In all positions, the dorsal SL intervals were restored after MBT and MHT. The volar SL interval widened in the extension position after volar SLIL resection. The volar SL interval was not restored in the extension position after MBT and MHT. The SL angle increased in the neutral and CF positions under the whole SLIL resection condition. The SL angle was not restored in the neutral and CF positions after MBT and MHT. The RL angle increased in the neutral and CF positions under the whole SLIL resection condition. The RL angle was not restored in the neutral and CF positions after MBT and MHT. Conclusion: The MBT and MHT may restore the dorsal SL interval. No significant differences in restoration of the SL interval between MBT and MHT were found in the cadaveric models. Clinical relevance: No significant differences between MBT and MHT were found in the cadaveric models for SLIL reconstruction. When considering the complications due to volar incision and additional procedures in MHT, MBT may be a more efficient technique in terms of operative time and injury of the anterior structures during surgery, but further research is needed.

Three-dimensional kinematics of the lunate, hamate, capitate and triquetrum with type 1 or 2 lunate morphology

2017 ◽  
Vol 43 (4) ◽  
pp. 380-386 ◽  
Author(s):  
Shingo Abe ◽  
Hisao Moritomo ◽  
Kunihiro Oka ◽  
Kazuomi Sugamoto ◽  
Kenji Kasubuchi ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Wrist Joint ◽  
Three Dimensional ◽  
Wrist Flexion ◽  
Ulnar Deviation ◽  
Dart Throwing ◽  
Carpal Kinematics ◽  
Throwing Motion

The purpose of this study was to investigate the differences in three-dimensional carpal kinematics between type 1 and 2 lunates. We studied 15 instances of wrist flexion to extension (nine type 1, six type 2), 13 of radial to ulnar deviation (seven type 1, six type 2), and 12 of dart-throwing motion (six each of type 1 and 2) in 25 normal participants based on imaging with computerized tomography. Mean proximal translation of the distal articular midpoint of the triquetrum relative to type 2 lunates during wrist radioulnar deviation was 2.9 mm (standard deviation (SD) 0.7), which was significantly greater than for type 1 lunates, 1.6 mm (SD 0.6). The hamate contacted the lunate in ulnar deviation and ulnar flexion of wrists with type 2 lunates but not with type 1. We conclude that the four-corner kinematics of the wrist joint are different between type 1 and 2 lunates.

scholarly journals Design of Shape Memory Alloy-Based Soft Wearable Robot for Assisting Wrist Motion

2019 ◽  
Vol 9 (19) ◽  
pp. 4025 ◽  
Author(s):  
Jaeyeon Jeong ◽  
Ibrahim Bin Yasir ◽  
Jungwoo Han ◽  
Cheol Hoon Park ◽  
Soo-Kyung Bok ◽  
...  
Keyword(s):  
Shape Memory Alloy ◽  
Shape Memory ◽  
Degrees Of Freedom ◽  
Wrist Flexion ◽  
Wearable Robot ◽  
Maximum Torque ◽  
Wrist Motion ◽  
Contraction Ratio ◽  
Flexion Extension ◽  
The Average Range

In this paper, we propose a shape memory alloy (SMA)-based wearable robot that assists the wrist motion for patients who have difficulties in manipulating the lower arm. Since SMA shows high contraction strain when it is designed as a form of coil spring shape, the proposed muscle-like actuator was designed after optimizing the spring parameters. The fabricated actuator shows a maximum force of 10 N and a maximum contraction ratio of 40%. The SMA-based wearable robot, named soft wrist assist (SWA), assists 2 degrees of freedom (DOF) wrist motions. In addition, the robot is totally flexible and weighs 151g for the wearable parts. A maximum torque of 1.32 Nm was measured for wrist flexion, and a torque of larger than 0.5 Nm was measured for the other motions. The robot showed the average range of motion (ROM) with 33.8, 30.4, 15.4, and 21.4 degrees for flexion, extension, ulnar, and radial deviation, respectively. Thanks to the soft feature of the SWA, time cost for wearing the device is shorter than 2 min as was also the case for patients when putting it on by themselves. From the experimental results, the SWA is expected to support wrist motion for diverse activities of daily living (ADL) routinely for patients.

Functional Reorganization in Chronic Hemiparetic Patients after Training: fMRI Studies

2006 ◽  
Vol 321-323 ◽  
pp. 1016-1021
Author(s):  
Ki Sik Tae ◽  
Sung Jae Song ◽  
So Young Lee ◽  
Gi Young Park ◽  
Chul Ho Sohn ◽  
...  
Keyword(s):  
Training Program ◽  
Upper Limb ◽  
Hand Movement ◽  
Active Movement ◽  
Wrist Flexion ◽  
Motor Tasks ◽  
Neural Basis ◽  
Motor Network ◽  
Flexion Extension ◽  
Before And After

The aim of this study was to evaluate effects of short-term repetitive-bilateral exercise on the activation of motor network using functional magnetic resonance imaging (fMRI). Eight control subjects and four chronic hemiparetic patients were investigated for the present study. The training program with a symmetrical upper-limb motion trainer was performed at 1 hr/day, 5 days/week during 6 weeks. Fugl-Meyer assessments (FMA) were performed every two weeks during the training. We compared cerebral and cerebellar cortical activations in two different tasks before and after the training program: (1) the only unaffected hand movement (Task 1), and (2) passive movements of the affected hand by the active movement of the unaffected hand (Task 2). fMRI was performed at 3T with wrist flexion-extension movement at 1 Hz during the motor tasks. All patients showed significant improvements of FMA scores in their paretic limbs after training. fMRI studies in Task 1 showed that cortical activations decreased in ipsilateral SMC but increased in contralateral sensorimotor cortex (SMC) and ipsilateral cerebellum (CRB). Task 2 showed cortical reorganizations in bilateral SMC, pre-motor area (PMA), supplementary area (SMA) and CRB. This study demonstrated that plastic changes of motor network occurred as a neural basis of the improvement subsequent to repetitive-bilateral exercises using the symmetrical upper-limb motion trainer.

Prediction of Ligament Length During Wrist Flexion Extension

2008 ◽  
Author(s):  
Rita M. Patterson ◽  
Naoya Yazaki ◽  
Clark R. Andersen ◽  
Newt H. Scott ◽  
Steven F. Viegas
Keyword(s):  
Direct Measurement ◽  
High Precision ◽  
Carpal Bones ◽  
Short Length ◽  
Ligament Length ◽  
Wrist Flexion ◽  
Wrist Motion ◽  
Flexion Extension ◽  
Carpal Ligaments ◽  
Precision Motion

Direct measurement of ligament length in the wrist is difficult due to constrained space and short length of many ligaments. No prior studies have reported measurements of ligament length between the carpal bones of the wrist. In this presentation, we have combined high precision motion analysis of the carpal bones, subsequent manual digitization of the ligament attachment regions, and a simulated ligament wrapping model, to generate predictions of carpal ligaments’ length and implied strain during wrist motion.

Arthroscopic dorsal capsulodesis for isolated lunotriquetral interosseous ligament injuries

2021 ◽  
pp. 175319342098368
Author(s):  
Mehmet A. Acar ◽  
Ali Özdemir ◽  
Ebubekir Eravsar
Keyword(s):  
Wrist Flexion ◽  
Ligament Injuries ◽  
Level Of Evidence ◽  
Interosseous Ligament ◽  
Pain Scores ◽  
Lunotriquetral Ligament ◽  
Flexion Extension ◽  
Patient Reported ◽  
Contralateral Hand ◽  
Patient Pain

We assessed the outcomes of isolated lunotriquetral ligament injuries in ten patients who underwent arthroscopic dorsal capsulodesis. Data from patient records, radiologic images and arthroscopic video records were evaluated. The patients were evaluated for ulnar-sided wrist pain with history and physical examination. Preoperative radiographs and MRIs for pain aetiology were assessed. The patients underwent arthroscopic dorsal capsulodesis and were evaluated 29 months (range 19–45) after surgery. Nine patients returned to their original jobs. In one patient pain was aggravated with heavy activities. Mean scapholunate angle was 44°. There were significant improvements postoperatively in pinch and grip strength and MAYO wrist, patient-reported wrist evaluation and pain scores. The wrist flexion–extension and the radial ulnar deviation were significantly improved compared with the contralateral hand. We conclude that arthroscopic dorsal capsulodesis offers effective management for isolated lunotriquetral interosseous ligament injuries. Level of evidence: IV

scholarly journals Sustained Isometric Wrist Flexion and Extension Maximal Voluntary Contractions on Corticospinal Excitability to Forearm Muscles during Low-Intensity Hand-Gripping

2020 ◽  
Vol 10 (7) ◽  
pp. 445
Author(s):  
Davis A. Forman ◽  
Garrick N. Forman ◽  
Bernadette A. Murphy ◽  
Michael W. R. Holmes
Keyword(s):  
Muscle Activity ◽  
Motor Evoked Potentials ◽  
Corticospinal Excitability ◽  
Wrist Flexion ◽  
Wrist Extension ◽  
Flexion Extension ◽  
Before And After ◽  
Muscle Groups ◽  
Voluntary Contractions ◽  
Wrist Flexors

The wrist extensors demonstrate an earlier fatigue onset than the wrist flexors. However, it is currently unclear whether fatigue induces unique changes in muscle activity or corticospinal excitability between these muscle groups. The purpose of this study was to examine how sustained isometric wrist extension/flexion maximal voluntary contractions (MVCs) influence muscle activity and corticospinal excitability of the forearm. Corticospinal excitability to three wrist flexors and three wrist extensors were measured using motor evoked potentials (MEPs) elicited via transcranial magnetic stimulation. Responses were elicited while participants exerted 10% of their maximal handgrip force, before and after a sustained wrist flexion or extension MVC (performed on separate sessions). Post-fatigue measures were collected up to 10-min post-fatigue. Immediately post-fatigue, extensor muscle activity was significantly greater following the wrist flexion fatigue session, although corticospinal excitability (normalized to muscle activity) was greater on the wrist extension day. Responses were largely unchanged in the wrist flexors. However, for the flexor carpi ulnaris, normalized MEP amplitudes were significantly larger following wrist extension fatigue. These findings demonstrate that sustained isometric flexion/extension MVCs result in a complex reorganization of forearm muscle recruitment strategies during hand-gripping. Based on these findings, previously observed corticospinal behaviour following fatigue may not apply when the fatiguing task and measurement task are different.

Rebalancing the tetraplegic wrist using extensor carpi ulnaris-tenodesis

2012 ◽  
Vol 38 (1) ◽  
pp. 22-28 ◽  
Author(s):  
C. Reinholdt ◽  
J. Fridén
Keyword(s):  
Grip Strength ◽  
Motion Correction ◽  
Wrist Joint ◽  
Cervical Spinal Cord ◽  
Wrist Flexion ◽  
Extensor Carpi Ulnaris ◽  
Flexion Extension ◽  
Cord Injury ◽  
Joint Flexion ◽  
Flexion And Extension

Patients with cervical spinal cord injury and tetraplegia often present with a radial deviation deformity of the wrist owing to impaired active wrist flexion and extension. Tenodesis of the extensor carpi ulnaris can help optimize grip strength. The purpose of the study was to compare reconstruction of the grip with and without extensor carpi ulnaris-tenodesis, as well as evaluating the outcome of the procedure. The grip strength of the group with tenodesis of the extensor carpi ulnaris was twice as strong as of the group without the tenodesis and with similar wrist joint flexion–extension range of motion. Correction of the wrist deformity enables a more ergonomic use of the hand. This may also help prevent shoulder pain, which is common among patients with tetraplegia.

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