The biomechanical effects of simulated radioscapholunate fusion with distal scaphoidectomy, 4-corner fusion with complete scaphoidectomy, and proximal row carpectomy compared to the native wrist
The Journal of Hand Surgery May 04, 2021
Saiz A, Delman CM, Haffner M, et al. - This study was conducted to ascertain the impact of simulated radioscapholunate fusion with distal scaphoid excision (RSLF+DSE), 4-corner fusion with scaphoidectomy (4-CF), and proximal row carpectomy (PRC) on the wrist’s range of motion (ROM), contact pressure, and contact force in a cadaveric model. Researchers tested ten freshly frozen cadaveric wrists under 4 sequential conditions: native wrist, RSLF+DSE, 4-CF, and PRC. Using two 1.6-mm Kirschner wires, the simulated fusions were performed. They assessed ROM in the flexion-extension and radioulnar deviation planes. They assessed contact area, contact pressure, and contact force at the scaphocapitolunate joint for the RSLF+DSE simulation and radiocarpal joint for the 4-CF and PRC simulations. This study’s findings demonstrate that for the treatment of stage II scapholunate advanced collapse, understanding the underlying native wrist biomechanics and alterations following different surgical treatments may assist hand surgeons in their clinical decision-making.
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