Biomechanical changes of the wrist flexor and extensor tendons following loss of scaphoid integrity

Tang, Jin Bo; Ryu, Jaiyoung; Han, Jung‐Soo; Omokawa, Shohei; Kish, Vincent; Wearden, Stanley

doi:10.1002/jor.1100150111

Cited by 14 publications

(6 citation statements)

References 31 publications

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“…This effect size indicates that the smallest detectable difference in mean moment arm magnitude is approximately 2 mm. The validity of the pre-hoc power analysis was verified by confirming that the effect sizes measured in this study were greater than or equal to those assumed from the literature [26]. …”

Section: Methodssupporting

confidence: 74%

“…Given the paucity of data characterizing how the mechanical actions of muscles change following surgical salvage procedures, it is difficult to interpret the clinical significance of the variability observed across these two studies. In contrast, at least six studies from different investigators have quantified moment arms for the nonimpaired wrist [19, 20, 23–26]. For all muscles examined, the nonimpaired moment arms in this study fell within two standard deviations of the average data reported among these six studies (Fig.…”

Section: Discussionmentioning

confidence: 42%

“…1D); the steel rod was connected to the second metacarpal via an external fixators. This setup is similar to previous wrist moment arm studies [20, 23–26]. …”

Section: Methodsmentioning

confidence: 89%

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Wrist salvage procedures alter moment arms of the primary wrist muscles

Nichols

Bednar

Havey

et al. 2015

Clinical Biomechanics

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Background Proximal row carpectomy and scaphoid-excision four-corner fusion are salvage procedures that relieve pain by removing arthritic joint surfaces. While numerous studies have examined how these procedures affect joint motion, few have examined how they influence muscle mechanical actions. This study examines whether muscle moment arms change after these procedures. Methods Moment arms of primary wrist muscles were measured in 8 cadaveric specimens using the tendon excursion method. In each specimen, moment arms were measured for two degrees of freedom (flexion-extension and radial-ulnar deviation) and three conditions (nonimpaired, scaphoid-excision four-corner fusion, and proximal row carpectomy). For each muscle and degree of freedom, moment arm versus joint angle curves for the three conditions were statistically compared. Findings Wrist salvage procedures significantly alter moment arms of the primary wrist muscles. Proximal row carpectomy primarily alters flexion-extension moment arms, while scaphoid-excision four-corner fusion primarily alters radial-ulnar deviation moment arms. Both procedures also alter the balance between agonist and antagonist wrist muscles. Following proximal row carpectomy, wrist extensors have smaller moment arms in extended postures. Following scaphoid-excision four-corner fusion, radial deviators have larger moment arms throughout radial-ulnar deviation. Interpretation Different moment arms indicate that different forces are required to complete the same tasks in nonimpaired and surgically altered wrists. The altered muscle moment arms likely contribute to post-operative impairments. Understanding how salvage procedures alter muscle mechanical actions is a critical first step toward identifying the cause of post-operative impairments and is necessary to develop effective interventions to augment deficient muscles and improve overall function.

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Section: Methodssupporting

confidence: 74%

Section: Discussionmentioning

confidence: 42%

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Wrist salvage procedures alter moment arms of the primary wrist muscles

Nichols

Bednar

Havey

et al. 2015

Clinical Biomechanics

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“…Studies related to normative data for grip and pinch are presented in different countries and serve as a reference in clinical practice in order to compare possible changes of grip strength and pinch, arising from different lesions of the upper limb 6,16 . Tang et al 17 describe that changes in biomechanical parameters of the wrist can be an important cause of diseases and dysfunctions. Alizadehkhaiyat et al 18 describe the fatigue as a possible etiology of wrist and elbow dysfunctions.…”

Section: Introductionmentioning

confidence: 99%

Fadiga dos músculos extensores do punho diminui a força de preensão palmar

et al. 2017

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RESUMO O objetivo deste estudo foi avaliar os efeitos de um protocolo de fadiga dos músculos extensores de punho na força de preensão e da pinça lateral através da dinamometria e eletromiografia de superfície (EMG). Foram selecionados 40 indivíduos do sexo masculino, divididos em dois grupos: preensão ou pinça lateral. O protocolo de fadiga foi baseado no teste de 1 Repetição Máxima (1-RM), seguido da realização do movimento de extensão de punho repetidas vezes com carga de 75% da 1-RM. Os voluntários realizaram as tarefas de preensão ou pinça lateral associadas à dinamometria. A EMG foi realizada para ambos os grupos, analisando o comportamento, segundo o protocolo, pela frequência mediana (FM) do extensor radial do carpo (ERC), do extensor ulnar do carpo (EUC) e do flexor superficial dos dedos (FD). A dinamometria de preensão ou pinça lateral e a EMG foram realizadas antes e após o protocolo de fadiga para ambos os grupos. O protocolo de fadiga foi eficaz na diminuição da força de preensão palmar (43,5±3,85 kgf inicial e 36,50±5,1 kgf final) e da pinça lateral (10,26±1,01 kgf inicial e 8,54±0,86 kgf final), bem como na diminuição da FM, sugerindo uma condição de fadiga do EUC no grupo preensão. Os achados do presente estudo possibilitam relacionar a fadiga dos extensores de punho à diminuição de força em atividades funcionais, como a preensão, o que pode implicar em disfunções musculoesqueléticas do membro superior.

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“…1,2 When the scaphoid is fractured, its role is accentuated, as the ligaments affect the stability of the fracture fragments. It is, therefore, important for the assessment and repair of scaphoid fractures and/or ligament injuries to have an accurate anatomical knowledge of the ligament attachments and morphology.…”

mentioning

confidence: 99%