Subscribe to RSS
DOI: 10.1055/s-0041-1732412
Biomechanical Comparison of Dart-Throw Motions after Partial Wrist Fusions
Funding The study was funded by the Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York.
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.
Ethical Approval
This article is a basic science study that used cadaver specimens. the authors have acquired Biosafety Committee approval for the use of cadaver material. This study did not involve any human participants and therefore should not require any Institutional Review Board (IRB) review.
Publication History
Received: 16 February 2021
Accepted: 15 June 2021
Article published online:
05 August 2021
© 2021. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Gellman H, Kauffman D, Lenihan M, Botte MJ, Sarmiento A. An in vitro analysis of wrist motion: the effect of limited intercarpal arthrodesis and the contributions of the radiocarpal and midcarpal joints. J Hand Surg Am 1988; 13 (03) 378-383
- 2 Meyerdierks EM, Mosher JF, Werner FW. Limited wrist arthrodesis: a laboratory study. J Hand Surg Am 1987; 12 (04) 526-529
- 3 Cohen MS, Kozin SH. Degenerative arthritis of the wrist: proximal row carpectomy versus scaphoid excision and four-corner arthrodesis. J Hand Surg Am 2001; 26 (01) 94-104
- 4 DiDonna ML, Kiefhaber TR, Stern PJ. Proximal row carpectomy: study with a minimum of ten years of follow-up. J Bone Joint Surg Am 2004; 86 (11) 2359-2365
- 5 Palmer AK, Werner FW, Murphy D, Glisson R. Functional wrist motion: a biomechanical study. J Hand Surg Am 1985; 10 (01) 39-46
- 6 Garg R, Kraszewski AP, Stoecklein HH. et al. Wrist kinematic coupling and performance during functional tasks: effects of constrained motion. J Hand Surg Am 2014; 39 (04) 634-642.e1
- 7 Moritomo H, Apergis EP, Herzberg G, Werner FW, Wolfe SW, Garcia-Elias M. 2007 IFSSH committee report of wrist biomechanics committee: biomechanics of the so-called dart-throwing motion of the wrist. J Hand Surg Am 2007; 32 (09) 1447-1453
- 8 Vardakastani V, Bell H, Mee S, Brigstocke G, Kedgley AE. Clinical measurement of the dart throwing motion of the wrist: variability, accuracy and correction. J Hand Surg Eur Vol 2018; 43 (07) 723-731
- 9 Crisco JJ, Heard WMR, Rich RR, Paller DJ, Wolfe SW. The mechanical axes of the wrist are oriented obliquely to the anatomical axes. J Bone Joint Surg Am 2011; 93 (02) 169-177
- 10 Kane PM, Vopat BG, Mansuripur PK. et al. Relative contributions of the midcarpal and radiocarpal joints to dart-thrower's motion at the wrist. J Hand Surg Am 2018; 43 (03) 234-240
- 11 Got C, Vopat BG, Mansuripur PK, Kane PM, Weiss AP, Crisco JJ. The effects of partial carpal fusions on wrist range of motion. J Hand Surg Eur Vol 2016; 41 (05) 479-483
- 12 Berger RA. A method of defining palpable landmarks for the ligament-splitting dorsal wrist capsulotomy. J Hand Surg Am 2007; 32 (08) 1291-1295
- 13 Nagurka ML, Hayes WC. An interactive graphics package for calculating cross-sectional properties of complex shapes. J Biomech 1980; 13 (01) 59-64
- 14 Brigstocke GHO, Hearnden A, Holt C, Whatling G. In-vivo confirmation of the use of the dart thrower's motion during activities of daily living. J Hand Surg Eur Vol 2014; 39 (04) 373-378
- 15 Han KD, Kim JM, DeFazio MV. et al. Changes in wrist motion after simulated scapholunate arthrodesis: a cadaver study. J Hand Surg Am 2016; 41 (09) e285-e293
- 16 Gaston RG, Greenberg JA, Baltera RM, Mih A, Hastings H. Clinical outcomes of scaphoid and triquetral excision with capitolunate arthrodesis versus scaphoid excision and four-corner arthrodesis. J Hand Surg Am 2009; 34 (08) 1407-1412
- 17 Wyrick JD, Stern PJ, Kiefhaber TR. Motion-preserving procedures in the treatment of scapholunate advanced collapse wrist: proximal row carpectomy versus four-corner arthrodesis. J Hand Surg Am 1995; 20 (06) 965-970