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Wrist kinematics after radiolunate arthrodesis

Archives of Orthopaedic and Trauma Surgery volume 135, pages 1033–1041 (2015)Cite this article

Abstract

Introduction

Analysis of carpal kinematics after radiolunate and radioscapholunate arthrodesis shows good preservation of midcarpal joint congruity and motion. However, no biomechanical data exist on carpal kinematics after radiolunate arthrodesis in the wrist. Purpose of this study was to examine the individual motion of scaphoid, capitate and triquetrum after simulated radiolunate arthrodesis.

Materials and methods

Radiolunate arthrodesis was simulated in three fresh human cadaver wrists by means of Kirschner wires. Individual motion of the scaphoid, triquetrum and capitate relative to the radius was measured for extension/flexion and radial–ulnar deviation before and after arthrodesis. Photostereogrammetric measurement was carried out and the helical axis concept of motion was employed.

Results

Global wrist motion, corresponding to capitate motion, was found to be reduced 33–50 % for extension/flexion and 25–43 % for radial–ulnar deviation. Relative motion of the scaphoid for extension/flexion was found to be reduced 20 % more and for radial–ulnar deviation 10 % more than that of the capitate. Relative motion of the triquetrum for extension/flexion was found to be reduced 30 % more and for radial–ulnar deviation 20 % more than that of the capitate. The pattern of motion of the capitate hardly changed, and that of the scaphoid, only slightly. The triquetrum lost its rotational pattern of motion and gave way to tilting movements instead. The physiological function of the scaphoid between distal radius and distal carpal row was preserved.

Conclusion

The presented data conform with the good clinical results obtained after radiolunate arthrodesis in the rheumatoid wrist and furthermore, encourage its use in the posttraumatic wrist.

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Acknowledgments

We are much indebted to Prof. J. Fasel of the Department of Anatomy, University of Geneva, Switzerland, for the anatomical specimens used in this investigation. This research received no specific grant from any funding agency in the public, commercial, or non-profit sectors.

Conflict of interest

The authors certify that they have no financial or personal relationship with other people or organisations that could appropriately bias this work. The named authors declare that they have no conflicts of interest to disclose.

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Affiliations

  1. Abteilung für Handchirurgie, Plastische und Wiederherstellungschirurgie, Klinikum Mittelbaden, Baden-Baden Annaberg, Lilienmattstr. 5, 76530, Baden-Baden, Germany

    Nicola Borisch

  2. Gernstr. 128, 8409, Winterthur, Switzerland

    H. A. Jacob

Authors
  1. Nicola Borisch
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  2. H. A. Jacob
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Correspondence to Nicola Borisch.

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Borisch, N., Jacob, H.A. Wrist kinematics after radiolunate arthrodesis. Arch Orthop Trauma Surg 135, 1033–1041 (2015). https://doi.org/10.1007/s00402-015-2244-4

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  • DOI: https://doi.org/10.1007/s00402-015-2244-4

Keywords

  • Radiolunate arthrodesis
  • Rheumatoid wrist
  • Wrist kinematics
  • Carpal bone motion