Article ID Journal Published Year Pages File Type
4069155 The Journal of Hand Surgery 2009 6 Pages PDF
Abstract

PurposeTo examine the biomechanical effects of triquetral and scaphoid excision on wrist motion and radiolunate contact characteristics in a cadaveric model after simulated 4-corner arthrodesis with rigid internal fixation.MethodsTen fresh-frozen cadaveric upper extremities were studied. For all surgical manipulations, the motion was measured and contact characteristics were assessed using ultralow prescale pressure-sensitive film.ResultsCompared with the intact specimen, simple 4-corner arthrodesis with scaphoid retention led to a significant decrease in flexion (–23%), extension (–69%), radial deviation (–129%), and ulnar deviation (–25%), but no significant change in radiolunate contact characteristics. After 4-corner arthrodesis with scaphoid excision, there was a significant increase in radial deviation (+213%) without significant change in radiolunate contact characteristics, but average radial deviation was still less than in the intact specimen. After further excision of the triquetrum, radial deviation increased significantly (+238%), to a mean value 5% greater than that of the intact state, but at the cost of a significant increase in mean radiolunate contact pressure (+44% compared to the intact state).ConclusionsWhen performing 4-corner arthrodesis, scaphoid and triquetrum excision may improve motion at the cost of increased mean radiolunate contact pressure.

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