In Reply

Abstract

9. Winter JA, Allen TJ, Proske U. Muscle spindle signals combine with the sense of effort to indicate limb position. J Physiol 2005;568: 1035-1046. 10. Johansson H, Sjolander P, Sojka P. A sensory role for the cruciate ligaments. Clin Orthop 1991:161-178. 11. Sjolander P, Johansson H, Djupsjobacka M. Spinal and supraspinal effects of activity in ligament afferents. J Electromyogr Kinesiol 2002;12:167-176. 12. Hagert E, Garcia-Elias M, Forsgren S, Ljung BO. Immunohistochemical analysis of wrist ligament innervation in relation to their structural composition. J Hand Surg 2007;32A:30 -36. 13. Ferreres A, Suso S, Ordi J, Llusa M, Ruano D. Wrist denervation. Anatomical considerations. J Hand Surg 1995;20B:761-768. 14. Hagert E, Persson JK, Werner M, Ljung BO. Evidence of wrist proprioceptive reflexes elicited after stimulation of the scapholunate interosseous ligament. J Hand Surg 2009;34A:642-651.In Reply:We did, in fact, conclude our paper stating, "Posterior interosseous sensory neurectomy is not associated with diminished wrist proprioception." We have been asked to comment on that. Based on our observations and the study that we carried out, an individual's ability to mimic position sense of the wrist in space was not altered when compared to his or her nonsurgical wrist or when compared to a standard developed by testing completely intact, unimpaired patients' wrists. We did not find any significant negative deviation in the surgical wrists of any patient in whom a posterior interosseous sensory neurectomy was performed.Our surprise finding was that the ability to mimic position sense in the intact individual was often in error. The same modest degree of inaccuracy was noted in patients' surgical and nonsurgical wrists. Based on these findings, we feel confident in our closing statement that posterior interosseous sensory neurectomy is not associated with diminished wrist proprioception.We thank The Journal of Hand Surgery for the opportunity to address this issue.