Dynamic assessment of the wrist after total wrist arthroplasty

2017 ◽  
Vol 42 (6) ◽  
pp. 573-579 ◽  
Author(s):  
H.P. Singh ◽  
D. Bhattacharjee ◽  
J.J. Dias ◽  
I. Trail
Keyword(s):  
Grip Strength ◽  
Dynamic Assessment ◽  
Hand Function ◽  
Normal Volunteer ◽  
Total Wrist Arthroplasty ◽  
Flexion Extension ◽  
Patient Reported ◽  
Function Test ◽  
Sollerman Hand Function Test ◽  
Wrist Arthroplasty

Our aim was to assess the outcome in patients with total wrist arthroplasty performed for end stage wrist osteoarthritis. We analysed the ranges of motion of operated and un-operated wrists using a flexible electrogoniometer during the Sollerman hand function test. We assessed grip strength with a digital dynamometer and completed patient reported outcome scores more than one year post-operatively. We reviewed 12 patients with a mean age of 64 (range 48–82) years. The flexion-extension arc was 72% and radioulnar deviation arc was 53% of the un-operated side but the total range of motion (area of circumduction) was 43% of the un-operated side and only 20% of the circumduction in age and gender-matched normal volunteers. Peak grip strength was 68% of the un-operated side. The patients reported good outcome with mean Michigan Hand Questionnaire (MHQ) scores of 56 (range 25–84) and mean Patient Evaluation Measure (PEM) scores of 39 (range 20–68). Patients completed the activities of Sollerman hand function test in twice the time (6 min) as required for a normal volunteer (2.8 min). The circumduction ellipses were narrow and central with limited radio-ulnar deviation and small mean areas of motion during activities of daily living.

scholarly journals Proximal Row Carpectomy with Total Scapoidectomy vs. Conventional Carpal Resection for ReMotion Total Wrist Arthroplasty

2021 ◽  
Vol 10 (9) ◽  
pp. 1865
Author(s):  
Stefan M. Froschauer ◽  
Matthias Holzbauer ◽  
Dietmar Hager ◽  
Oskar Kwasny ◽  
Dominik Duscher
Keyword(s):  
Grip Strength ◽  
Clinical Assessment ◽  
Complication Rates ◽  
Proximal Row Carpectomy ◽  
Prosthesis Implantation ◽  
Total Wrist Arthroplasty ◽  
Significant Difference ◽  
Flexion Extension ◽  
Wrist Arthroplasty

High complication rates in total wrist arthroplasty (TWA) still lead to controversy in the medical literature, and novel methods for complication reduction are warranted. In the present retrospective cohort study, we compare the outcomes of the proximal row carpectomy (PRC) method including total scaphoidectomy (n = 22) to the manufacturer’s conventional carpal resection (CCR) technique, which retains the distal pole of the scaphoid (n = 25), for ReMotion prosthesis implantation in non-rheumatoid patients. Mean follow-up was 65.8 ± 19.8 and 80.0 ± 28.7 months, respectively. Pre- and postoperative clinical assessment included wrist flexion-extension and radial-ulnar deviation; Disability of Arm, Shoulder, and Hand scores; and pain via visual analogue scale. At final follow-up, grip strength and satisfaction were evaluated. All complications, re-operations, and revision surgeries were noted. Clinical complications were significantly lower in the PRC group (p = 0.010). Radial impaction was detected as the most frequent complication in the CCR group (n = 10), while no PRC patients suffered from this complication (p = 0.0008). Clinical assessment, grip strength measurements, and the log rank test evaluating the re-operation as well as revision function showed no significant difference. All functional parameters significantly improved compared to preoperative values in both cohorts. In conclusion, we strongly recommend PRC for ReMotion prosthesis implantation.

Total Wrist Arthroplasty Alignment and Its Potential Association with Clinical Outcomes

2021 ◽  
Author(s):  
Bardiya Akhbari ◽  
Kalpit N. Shah ◽  
Amy M. Morton ◽  
Janine Molino ◽  
Douglas C. Moore ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Outcomes ◽  
Three Dimensional ◽  
Radial Component ◽  
Single Type ◽  
Radiographic Images ◽  
Computed Tomography Images ◽  
Total Wrist Arthroplasty ◽  
Flexion Extension ◽  
Wrist Arthroplasty

Abstract Purpose There is a lack of quantitative research that describes the alignment and, more importantly, the effects of malalignment on total wrist arthroplasty (TWA). The main goal of this pilot study was to assess the alignment of TWA components in radiographic images and compare them with measures computed by three-dimensional analysis. Using these measures, we then determined if malalignment is associated with range of motion (ROM) or clinical outcomes (PRWHE, PROMIS, QuickDash, and grip strength). Methods Six osteoarthritic patients with a single type of TWA were recruited. Radiographic images, computed tomography images, and clinical outcomes of the wrists were recorded. Using posteroanterior and lateral radiographs, alignment measurements were defined for the radial and carpal components. Radiographic measurements were validated with models reconstructed from computed tomography images using Bland–Altman analysis. Biplanar videoradiography (<1mm and <1 degree accuracy) was used to capture and compute ROM of the TWA components. Linear regression assessed the associations between alignment and outcomes. Results Radiographic measures had a 95% limit-of-agreement (mean difference ±  1.96 × SD) of 3 degrees and 3mm with three-dimensional values, except for the measures of the carpal component in the lateral view. In our small cohort, wrist flexion–extension and radial–ulnar deviation were correlated with volar–dorsal tilt and volar–dorsal offset of the radial component and demonstrated a ROM increase of 3.7 and 1.6 degrees per degree increase in volar tilt, and 10.8 and 4.2 degrees per every millimeter increase in volar offset. The carpal component's higher volar tilt was also associated with improvements in patient-reported pain. Conclusions We determined metrics describing the alignment of TWA, and found the volar tilt and volar offset of the radial component could potentially influence the replaced wrist's ROM. Clinical Relevance TWA component alignment can be measured reliably in radiographs, and may be associated with clinical outcomes. Future studies must evaluate its role in a larger cohort.

Re-motion total wrist arthroplasty: 39 non-rheumatoid cases with a mean follow-up of 7 years

2019 ◽  
Vol 44 (9) ◽  
pp. 946-950 ◽  
Author(s):  
Stefan M. Froschauer ◽  
Maximilian Zaussinger ◽  
Dietmar Hager ◽  
Manfred Behawy ◽  
Oskar Kwasny ◽  
...  
Keyword(s):  
Radial Component ◽  
Visual Analogue Scale Pain ◽  
Wrist Flexion ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Total Wrist Arthroplasty ◽  
Flexion Extension ◽  
Analogue Scale Pain ◽  
Wrist Arthroplasty

We evaluated the outcomes of the Re-motion total wrist arthroplasty in 39 non-rheumatoid patients. The mean follow-up was 7 years (range 3–12). Postoperative wrist flexion-extension and radial-ulnar deviation as well as the scores of the Disability of Arm Shoulder and Hand questionnaire and the visual analogue scale pain scores improved significantly. Complications occurred in 13 wrists, five of which required further surgery. The most frequent complication was impingement between the scaphoid and the radial implant (n = 5), which can be avoided by complete or almost complete scaphoid resection. Periprosthetic radiolucency developed around the radial component in three cases and three radial screws loosened. Despite the incidence of high implant survival in 38 of 39 wrists over 7 years (97%), the complication rate is not satisfying. Knowledge of the risk of complications and patient selection are essential when making the decision to choose wrist arthroplasty over arthrodesis. Level of evidence: IV

THE EFFECT OF ARTICULAR SURFACE SHAPE AND TENDON FORCES OF TOTAL WRIST ARTHROPLASTY SYSTEMS: A FINITE ELEMENT STUDY

2012 ◽  
Vol 15 (04) ◽  
pp. 1250021 ◽  
Author(s):  
Matthew B. A. McCullough ◽  
Brian D. Adams ◽  
Nicole M. Grosland
Keyword(s):  
Finite Element ◽  
Articular Surface ◽  
Surface Shape ◽  
Element Analysis ◽  
Future Directions ◽  
Ulnar Deviation ◽  
Articular Surfaces ◽  
Total Wrist Arthroplasty ◽  
Flexion Extension ◽  
Wrist Arthroplasty

In order to better understand the behavior of the total wrist implant systems, finite element analysis (FEA) was used to model the articular surfaces of two unconstrained total wrist arthroplasty (TWA) devices. After creating models based on manufacturer specifications, simulations of flexion, extension, radial deviation, ulnar deviation and circumduction were run with simulated moments from surrounding tendons under displacement control. In addition, simulations were run under positioning that represented a pronated and supinated forearm as well as unstable conditions. Understanding implant behavior and capabilities as related to the shape of the articular surfaces is important for proper prescription of implants as well as determining future directions for the design of arthroplasty devices.

scholarly journals Pengaruh transfer of motor skill learning dari tangan sehat terhadap peningkatan fungsional tangan paresis pasien stroke subakut

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Elina . ◽  
Lidwina S. Sengkey
Keyword(s):  
Motor Skill ◽  
Hand Function ◽  
Skill Learning ◽  
Medical Rehabilitation ◽  
Wilcoxon Test ◽  
Motor Skill Learning ◽  
Subacute Stroke ◽  
Function Test ◽  
Sollerman Hand Function Test ◽  
Nine Hole Peg Test

Abstract: This study aimed to demonstrate the effect of transfer of motor skill learning from healthy hand on increasing functional paretic’s hand of stroke patient. This was a descriptive study conducted at the Instalation of Medical Rehabilitation, Prof. Dr. R. D. Kandou Hospital Manado. There were 26 patients of subacute stroke that fulfilled the inclusion criteria. All subjects were trained for 6 weeks and then were evaluated with nine hole peg test dan Sollerman hand function test. The results showed that of the 26 patients, 15 (57.7%) were males. The highest percentages were as follows: mean of age was 57.58 years old (38.5%), onset of stroke was less than 10 weeks (65.4%), and nonhaemorrhagic stroke (88.5%). The Wilcoxon test showed that there were significant differences of nine hole peg test and Sollerman hand function test scores before and after exercise (P <0.001). Conclusion: Transfer of motor skill learning from healthy hand could increase functional paretic hand of stroke patients.Keywords: stroke, transfer of motor skill, bilateral transfer, mirror neuronAbstrak: Penelitian ini bertujuan untuk membuktikan pengaruh transfer of motor skill learning tangan sehat terhadap peningkatan fungsional tangan paresis pasien stroke subakut. Jenis penelitian ini ialah deskriptif. Penelitian dilaksanakan di Instalasi Rehabilitasi Medik RSUP Prof Dr. R. D. Kandou Manado. Sebanyak 26 orang pasien stroke fase subakut yang memenuhi kriteria inklusi. Semua subyek diberi latihan selama 6 minggu kemudian dilakukan penilaian dengan nine hole peg test dan Sollerman hand function test. Hasil penelitian memperlihatkan dari 26 subjek, persentase tertinggi ialah laki-laki sebanyak 15 orang (57,7%), usia rata-rata ialah 57,58 tahun (38,5%), onset terjadinya stroke kurang dari 10 minggu (65,4%), dan stroke non-hemoragik (88,5%). Hasil uji Wilcoxon menyatakan terdapat perbedaan bermakna pada nilai nine hole peg test dan Sollerman hand function test sebelum (awal) dan sesudah (akhir) perlakuan (p <0,001). Simpulan: Transfer of motor skill learning tangan yang sehat dapat meningkatkan fungsional tangan paresis pasien stroke subakut.Kata kunci: stroke, transfer of motor skill, bilateral transfer, mirror neuron

Wrist arthrodesis as a salvage procedure for failed implant arthroplasty

2010 ◽  
Vol 36 (1) ◽  
pp. 29-33 ◽  
Author(s):  
M. Rizzo ◽  
D. B. Ackerman ◽  
R. L. Rodrigues ◽  
R. D. Beckenbaugh
Keyword(s):  
Soft Tissues ◽  
Poor Quality ◽  
Dash Score ◽  
Salvage Procedure ◽  
Wrist Arthrodesis ◽  
Pain Scores ◽  
Total Wrist Arthroplasty ◽  
Patient Reported ◽  
Wrist Arthroplasty

Salvage of failed total wrist arthroplasty by arthrodesis may be difficult because of bone loss and poor quality of bone and soft tissues. We examined the outcomes of wrist arthrodesis for failed total wrist arthroplasty in a retrospective study of 21 wrists in 17 patients. Clinical data, radiographs, patient-reported outcomes and DASH questionnaires were used. Thirteen women and four men had undergone total wrist arthroplasty at an average age of 55 years. The mode of failure was aseptic loosening in 13 wrists. The average time from the index arthroplasty to wrist arthrodesis was 7.6 years. Autograft and/or allograft bone graft was used in all of the wrists. Arthrodesis was achieved in 11 wrists and ten had a nonunion. Six arthrodeses underwent eight revisions for nonunion, with two achieving union. The mean DASH score was 29 in wrists that fused and 36 in those that did not fuse. Pain scores averaged 2.1 in the wrists that fused and 3.3 in the nonunion group. Most patients had clinical improvement.

Measurement and Co-Relation of Hand Span and Dexterity Function in Paediatric Population

2021 ◽  
pp. 237-241
Author(s):  
Dr. Vidhi Shah ◽  
Renuka Pangde ◽  
Padmaja Guruprasad ◽  
Sunita Padhi ◽  
Bhakti Panchal ◽  
...  
Keyword(s):  
Grip Strength ◽  
Negative Correlation ◽  
Handgrip Strength ◽  
Hand Function ◽  
Paediatric Population ◽  
Strong Negative Correlation ◽  
Geriatric Population ◽  
Hand Grip ◽  
Function Test ◽  
Time Required

<strong>Background</strong><br> The measure of handgrip strength is influenced by several factors including age, gender, different angle of shoulder, elbow,wrist and grip span . there is an optimal grip span at which maximum handgrip strength is obtained in adult.Hand span affect maximal and submaximal handgrip strengths. It was found that hand span affect grip strength, grip force and dexterity function in adult as well as geriatric population. In geriatric population hand grip function decreased with age.<br> <strong>Methodology</strong><br> Screening was done in 3 schools near PCMC area and students were selected as per the inclusion criteria. Total 150 children’s age from 6 to 16 years were selected from the convenient places. Hand span was measured in both hands (Dominant and Non-dominant) from the tip of the thumb to the tip of the small finger with the hand open as wide as possible. And the results of hand span measurement were rounded to nearest whole. The dexterity function was measured using Jebsen Taylor Hand Function Test. There were 7 subtests performed in the Jebsen Taylor Hand Function Test. <br> <strong>Results : </strong><br> The results shows that there was a strong negative correlation between the hand span and subtest1,2,3,7 of Jebsen Taylor Hand Function test. There was a moderate negative correlation between the subtest 4,5,6 of Jebsen Taylor Hand Function test. <br> <strong>Conclusion : </strong><br> In pediatrics, as the age increases, the hand span and hand grip strength increases but the time required to complete the subtest in Jebsen Taylor hand function test decreases. So the dexterity function improves.

scholarly journals Universal 2 Wrist Arthroplasty in Rheumatoid Arthritis

2017 ◽  
Vol 06 (03) ◽  
pp. 206-215 ◽  
Author(s):  
Giovanni Munz ◽  
Giulia Guidi ◽  
Massimo Ceruso ◽  
Sandra Pfanner
Keyword(s):  
Rheumatoid Arthritis ◽  
Pain Relief ◽  
Grip Strength ◽  
Visual Analogue Scale Pain ◽  
Level Of Evidence ◽  
Flexion Extension ◽  
The Mean ◽  
Wrist Arthroplasty

Purpose The aim of this study was to evaluate the mid- to long-term outcomes and complications in patients affected by rheumatic diseases treated with the Universal 2 (U2) total wrist arthroplasty (TWA). Methods We reviewed, in a retrospective, noncontrolled cohort study, 22 patients affected by rheumatoid arthritis (RA), who underwent U2 total wrist replacement between March 2003 and January 2014 for the treatment of 23 rheumatoid wrists with the aim of obtaining the remission of pain and a range of motion (ROM) useful for daily activities, according to the patients' demands, as an alternative to total wrist arthrodesis. The cohort of patients included 20 females and 2 males, with a mean age of 54.9 years. Residual pain, preoperative ROM, postoperative ROM increases, grip strength, radiographic changes, long-term complications, and reasons for revision or failures were evaluated. Results In this study, 22 patients were evaluated at a mean follow-up of 82.3 months (range: 2–12 years). All patients had good or complete pain relief, the mean visual analogue scale pain score was 0.82. The mean grip strength improved and postoperatively was 11 kg (Jamar). The mean total ROM of flexion–extension was 72.3 degrees; radial–ulnar deviation 24.9 degrees. The mean QuickDASH score of 49 and patient rate wrist/hand evaluation of 41.7 a revision surgical procedure in six cases (26%): in two cases, a carpal component revision procedure and in four cases, total implant failures requiring either conversion to a Swanson spacer or wrist joint fusion. Conclusion TWA provides pain relief, preserves motion, and improves function in severe degenerative RA. Our results at a mid- to long-term follow-up with the U2 prosthesis were encouraging and represent, when indicated, a valid alternative to fusion which is less appealing for RA patients. Level of Evidence Level of evidence is therapeutic IV.

PATIENT RELATED FUNCTIONAL OUTCOME AFTER TOTAL WRIST ARTHROPLASTY: A SINGLE CENTER STUDY OF 206 CASES

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 81-87 ◽  
Author(s):  
Marcus Sagerfors ◽  
Anil Gupta ◽  
Ole Brus ◽  
Marco Rizzo ◽  
Kurt Pettersson
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Outcome Measures ◽  
Performance Measure ◽  
Hand Grip Strength ◽  
Ulnar Deviation ◽  
Hand Grip ◽  
Total Wrist Arthroplasty ◽  
Patient Related Outcome ◽  
Wrist Arthroplasty

Objectives: To prospectively evaluate patient related outcome measures after total wrist arthroplasty (TWA) using four different total wrist implants operated at a single referral center in Sweden. Methods: 206 primary TWAs were assessed preoperatively and after one year postoperatively with respect to the following eight outcome measures: Range of motion (flexion/extension, radial/ulnar deviation, pronation/supination), hand grip strength, Canadian Occupational Performance Measure (COPM), performance and satisfaction, Visual Analog Scale (VAS) pain scores at rest and in activity. Results: The Maestro TWA had a significantly greater improvement of radial/ulnar deviation than the Biax and Remotion TWAs. COPM performance and satisfaction improved more for the Maestro and Universal 2 prostheses than the Biax and Remotion. Conclusions: All four TWAs offer reduced VAS-scores and improved COPM-scores with preserved hand grip strength and somewhat improved range of motion. The Maestro TWA performed favorably compared to the Remotion TWA. Implant design may affect patient related outcome.

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