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Rodriguez-Fontan F, Tucker NJ, Pflug EM, Leversedge FJ, Catalano LW, Lauder A. Proximal Hamate Reconstruction of Proximal Pole Scaphoid Nonunion: A Case Series and Analysis of Clinical Outcomes. Hand (N Y) 2024; 19:967-977. [PMID: 37161279 PMCID: PMC11342697 DOI: 10.1177/15589447231156210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Small proximal pole scaphoid nonunions present a clinical challenge influenced by fragment size, vascular compromise, deforming forces exerted through the scapholunate interosseous ligament (SLIL), and potential articular fragmentation. Osteochondral autograft options for proximal pole reconstruction include the medial femoral trochlea, costochondral rib, or proximal hamate. This study reports the clinical outcomes of patients treated with proximal hamate osteochondral autograft reconstruction. METHODS A retrospective review identified patients treated with this surgery from 2 institutions with a minimum 6-month follow-up. Clinical outcomes included the Visual Analog Dcale pain score, 12-item Short-Form survey, abbreviated Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, wrist and forearm range of motion (ROM), radiographic assessment, and complications. We reviewed and compared these outcomes with those of the current published literature. RESULTS Four patients (mean age: 24 years, 75% men) with a 12.8-month average follow-up (range: 6-20 months) were included. Radiographic union was identified in all cases by 12 weeks (range, 10-12). The average wrist ROM was 67.5% flexion/extension and 100% pronation/supination compared with the contralateral side at the final follow-up. The mean QuickDASH score was 17.6 (SD, 13). No complications were identified. CONCLUSIONS Proximal pole scaphoid nonunion reconstruction using autologous proximal hamate osteochondral graft demonstrated encouraging clinical and radiographic outcomes. Proximal hamate harvest involves minimal donor site morbidity without a distant operative site, uses an osteochondral graft with similar morphology to the proximal scaphoid, requires no microsurgical technique, and permits reconstruction of the SLIL using the volar capitohamate ligament.
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Affiliation(s)
| | - Nicholas J. Tucker
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Emily M. Pflug
- Department of Orthopedics, New York University Langone Health, New York City, USA
| | - Fraser J. Leversedge
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Louis W. Catalano
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alexander Lauder
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Department of Orthopedics, Denver Health Medical Center, Denver, CO, USA
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Burgess S. Universal optimal design in the vertebrate limb pattern and lessons for bioinspired design. BIOINSPIRATION & BIOMIMETICS 2024; 19:051004. [PMID: 39042109 DOI: 10.1088/1748-3190/ad66a3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 07/23/2024] [Indexed: 07/24/2024]
Abstract
This paper broadly summarizes the variation of design features found in vertebrate limbs and analyses the resultant versatility and multifunctionality in order to make recommendations for bioinspired robotics. The vertebrate limb pattern (e.g. shoulder, elbow, wrist and digits) has been proven to be very successful in many different applications in the animal kingdom. However, the actual level of optimality of the limb for each animal application is not clear because for some cases (e.g. whale flippers and bird wings), the basic skeletal layout is assumed to be highly constrained by evolutionary ancestry. This paper addresses this important and fundamental question of optimality by analysing six limbs with contrasting functions: human arm, whale flipper, bird wing, human leg, feline hindlimb and frog hindlimb. A central finding of this study is that the vertebrate limb pattern is highly versatile and optimal not just for arms and legs but also for flippers and wings. One key design feature of the vertebrate limb pattern is that of networks of segmented bones that enable smooth morphing of shapes as well as multifunctioning structures. Another key design feature is that of linkage mechanisms that fine-tune motions and mechanical advantage. A total of 52 biomechanical design features of the vertebrate limb are identified and tabulated for these applications. These tables can be a helpful reference for designers of bioinspired robotic and prosthetic limbs. The vertebrate limb has significant potential for the bioinspired design of robotic and prosthetic limbs, especially because of progress in the development of soft actuators.
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Affiliation(s)
- Stuart Burgess
- School of Electrical, Electronic and Mechanical Engineering, Bristol University, Bristol, United Kingdom
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Sarhan MY, Altamimi AA, Gharaibeh MA, Akel A, Abu Shokor M, Salem OA, Balbisi B, Abu-Jeyyab M. Evaluation of Normal Ranges of Wrist Radiologic Indexes in Jordanian Population. Orthop Rev (Pavia) 2024; 16:120049. [PMID: 39105053 PMCID: PMC11299902 DOI: 10.52965/001c.120049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 03/24/2024] [Indexed: 08/07/2024] Open
Abstract
Background The wrist is a complex joint that plays a role in several everyday tasks. Various radiological indices have been created to assess the alignment and structure of the wrist using standard X-ray images. Nevertheless, these indicators may differ based on variables such as age, gender, ethnicity, handedness, and wrist position. This research aimed to assess the radiological indices of the wrist in a group of healthy people from Jordan and investigate the impact of age and gender on these indices. Methods We obtained data from a sample of 385 patients who presented at our hospital with minor non-specific wrist pain and satisfied the specified criteria for inclusion. We conducted measurements of radial inclination, radial height, volar tilt, ulnar variance, and carpal height ratio using both anteroposterior and lateral views of the wrist. We used linear regression and independent sample t-test to examine the correlation between age, gender, and radiological indicators. The reliability of the measurements was assessed using the intraclass correlation coefficient (ICC). Results Our study revealed a negative correlation between age and carpal height ratio (r = -0.13, p = 0.03). However, no significant gender differences were seen in any of the radiological indices (p > 0.05). Our findings indicate that ulnar variance had the greatest level of reliability across observers, with an intra-observer intraclass correlation coefficient (ICC) of 0.95 and an inter-observer ICC of 0.8. Conversely, volar tilt exhibited the lowest inter-observer reliability, with an ICC of 0.1.Our results provide a valuable point of reference for the wrist morphology and alignment in the Jordanian population. Our suggestion is that the carpal height ratio might indicate alterations in the wrist joint due to aging, whereas ulnar variation may serve as a dependable indicator of wrist alignment. We suggest doing more research to investigate the biological and anatomical factors behind these results and to compare them with other demographic groups.
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Affiliation(s)
- Mohammed Y Sarhan
- Department of special surgery, faculty of medicin Hashemite University
| | - Anas Ar Altamimi
- Department of special surgery, faculty of medicine Hashemite University
| | | | - Alaa Akel
- epartment of special surgery, faculty of medicine Mutah University
| | | | | | - Basel Balbisi
- Department of special surgery, faculty of medicine Hashemite University
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Hong SJ, Lee MY, Lee BH. Effects of Wrist Stability Training Combined with Grip Strength Exercise on Pain and Function in Patients with Nonspecific Chronic Wrist Pain. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1144. [PMID: 39064574 PMCID: PMC11278657 DOI: 10.3390/medicina60071144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/28/2024] [Accepted: 07/11/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: Non-specific chronic wrist pain is wrist pain that occurs without a specific cause, such as trauma, and may limit the range of motion of the joints of the wrist and hand, affecting muscle strength, grip strength, and function. This study aimed to determine the effects of grip-strengthening exercises combined with wrist stability training on pain and function in patients with non-specific chronic wrist pain. Materials and Methods: The subjects of the study were 31 patients with wrist pain. To determine the effect of grip-strengthening exercises combined with wrist stability training, 15 participants participated in grip-strengthening exercises combined with wrist stability training and 16 control subjects participated. The experimental group participated in wrist-stability training. Grip-strengthening exercises combined with wrist stability training were performed for 20 min/day twice a week for 4 weeks, and relaxation massage and conservative physical therapy were performed for 20 min/day twice a week for 4 weeks. The control group received relaxation massage and conservative physical therapy for 40 min/day twice a week for 4 weeks. A visual pain scale was used to evaluate the degree of pain before and after treatment, and a patient-rated wrist evaluation was used to evaluate wrist function. Results: The results showed that the visual score significantly decreased in the time effect before and after the intervention in both groups (p < 0.001), patient-rated wrist evaluation significantly decreased (p < 0.001), and grip strength and muscle strength significantly increased (p < 0.001). The results of this study showed that grip-strengthening exercises combined with wrist stability training were effective in improving pain, function, grip strength, and muscle strength in patients with non-specific chronic wrist pain. Conclusions: Grip-strengthening exercises combined with wrist stability training can be used as an effective intervention method to improve pain, function, grip strength, and muscle strength, emphasizing the need for wrist exercise interventions in patients with non-specific chronic wrist pain in the future.
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Affiliation(s)
- Seung-Ji Hong
- Graduate School of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea;
| | - Mi-Young Lee
- Department of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea;
| | - Byoung-Hee Lee
- Department of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea;
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Deglmann CJ. [Osteoarthritis of the wrist]. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:463-476. [PMID: 38789591 PMCID: PMC11143053 DOI: 10.1007/s00132-024-04502-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 05/26/2024]
Abstract
The term osteoarthritis (OA) of the wrist can be used as an umbrella term for various, often independent areas of OA, as the wrist is made up of several joints. Radiocarpal OA often occurs after untreated ligament injuries, incorrectly healed bone fractures in the carpus or after radius fractures involving the joint. A typical sequence of propagation is known for radiocarpal OA following scapholunate (SL) insufficiency or scaphoid pseudarthrosis. Other causes include inflammation, crystal deposits or bone necrosis. Ulnocarpal arthrosis occurs posttraumatically or primarily when there are differences in levels between the ulna and radius. When treating wrist arthrosis, after conservative measures have been exhausted a surgical procedure should be chosen that enables the best possible load-bearing and residual mobility, considering the surgical risks and individual requirements. During salvage operations, the defective cartilage areas are either fused directly or eliminated using appropriate diverting partial fusions and resection arthroplasty. An accurate analysis of the affected zones is crucial for selecting an appropriate intervention.
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Affiliation(s)
- C J Deglmann
- MünchenHand - Privatpraxis für Hand- und Handgelenkchirurgie, Marienplatz 21, 80333, München, Deutschland.
- Deutsches Zentrum für Obere Extremität, Effnerstr. 38, 81925, München, Deutschland.
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Shi M, Wu H, Ruan H, Xu D, Deng L, Pang S. Using a golf specific functional movement screen to predict golf performance in collegiate golfers. PeerJ 2024; 12:e17411. [PMID: 38803584 PMCID: PMC11129693 DOI: 10.7717/peerj.17411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Background This study aims to examine the relationship between functional movements and golf performance using the Golf Specific Functional Movement Screen (GSFMS). Methods This cross-sectional study included a total of 56 collegiate golfers (aged 20.89 ± 0.99 years, height of 174.55 ± 7.76 cm, and weight 68.48 ± 9.30 kg) who met the criteria, and were recruited from Hainan Normal University in June 2022. The participants' golf motor skills (1-yard putt, 10-yard putt, 25-yard chip, 130/100-yard set shot, driver, and 9-hole stroke play) were tested and the GSFMS (e.g., pelvic tilt, pelvic rotation, and torso rotation) was used. Results There were significant weak or moderate correlations between the variables. Furthermore, a multiple linear regression analysis found that pelvic rotation and lower-body rotation abilities can significantly predict golf skill levels, which collectively explain 31.2% of the variance in golf skill levels among collegiate golfers (Adjusted R2 = 0.312, F = 2.663, p < 0.05). Standardised β values indicate that pelvic rotation (β = 0.398) has a more substantial impact on golf skill levels than lower-body rotation (β = 0.315). Conclusions This study found the weak to moderate correlations between the GSFMS and golf performance, and pelvic rotation and lower-body rotation abilities, thus predicting golf skills. Our findings provide novel insights into the relationship between functional abilities and comprehensive skill performance within the context of the Gray Cook's Movement Pyramid model, and provide theoretical support and practical reference for collegiate golf motor-skill learning and sports injury prevention.
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Affiliation(s)
- Min Shi
- Faculty of Physical Education, Hainan Normal University, Haikou, Hainan Province, China
- Hainan College of Software Technology, Qionghai, China
| | - Hua Wu
- Faculty of Physical Education, Hainan Normal University, Haikou, Hainan Province, China
| | - Hui Ruan
- Faculty of Physical Education, Hainan Normal University, Haikou, Hainan Province, China
| | - Dan Xu
- Hainan Provincial Sports Academy, Haikou, China
| | - Libo Deng
- Yulin Normal University, Yulin, China
| | - Shibo Pang
- Hainan College of Economics and Business, Haikou, China
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Gilmor R, Dubin JA, Bains SS, Monárrez R, Remily E, Hameed D, Ingari JV. An anatomic study of the morphologic characteristics of the dorsal capitolunate ligament. HAND SURGERY & REHABILITATION 2024; 43:101669. [PMID: 38395197 DOI: 10.1016/j.hansur.2024.101669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/25/2024]
Abstract
PURPOSE There is consensus in favor of a description of the dorsal ligaments of the carpus as not including a direct ligament between the lunate and capitate. On the other hand, there is an anatomical formation which, according to the currently accepted description, corresponds to the dorsal midcarpal capsule, itself thickened by the dorsal intercarpal ligament. The question is whether the capsule at this point deserves to be called an individualizable ligament. In our operative experience of the dorsal carpus, we have encountered a stout structure adherent to the lunate and capitate. In this article, we present the anatomic evidence of this structure's existence. METHODS Seven adult fresh frozen upper extremities were dissected. Three wrists were longitudinally sectioned in line with the middle finger metacarpal. The remaining 4 were dissected dorsally. Two representative samples of the stout structure connecting the lunate to the capitate were sent to pathology for histologic analysis and staining. RESULTS In all 3 of the longitudinally sectioned wrists, a thick band of tissue could clearly be seen, originating on the lunate, spanning the dorsal interval between the lunate and the capitate, and inserting on the capitate. With this structure intact, dorsal dislocation of the capitate was not possible, but preliminary sectioning of the structure allowed dislocation. In the 4 dorsally dissected wrists, the same connection was observed, palmar to the dorsal intercarpal ligament, in every specimen. The average dimensions of the dorsal capitolunate were: 15.25 ± 1 mm long, 8.75 ± 1 mm wide at the midpoint, and 1.75 ± 1 mm thick. The two specimens sent to pathology after sectioning showed longitudinally oriented collagen fibers. This structure also stained positive for elastin and contained intrasubstance vascular structures. CONCLUSION There is a stout ligamentous structure connecting the lunate to the capitate, palmar to the dorsal intercarpal ligament. Disruption of this structure appears to be necessary for dorsal dislocation of the capitate. Clinical studies are needed to gain better understanding of the exact function and importance of this structure.
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Affiliation(s)
- Ruby Gilmor
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, United States
| | - Jeremy A Dubin
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, United States
| | - Sandeep S Bains
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, United States
| | - Rubén Monárrez
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, United States
| | - Ethan Remily
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, United States
| | - Daniel Hameed
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, United States
| | - John V Ingari
- LifeBridge Health, Sinai Hospital of Baltimore, Rubin Institute for Advanced Orthopedics, Baltimore, MD, United States.
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Ivanov I, Ranchev S, Stoychev S. Experimental Ultrasound Approach for Studying Knee Intra-Articular Femur-Tibia Movements under Different Loads. J Funct Morphol Kinesiol 2023; 9:8. [PMID: 38249085 PMCID: PMC10801608 DOI: 10.3390/jfmk9010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
The purpose of the present study was to develop an experimental model for the study of intra-articular knee movements depending on the function of the knee joint and involved muscle groups under isometric stretching conditions with different loads. The experimental procedure included an ultrasound examination of a knee joint after isometric stretching in healthy men (n = 32). The changes (in millimeters) in the distances between the femur and tibia were measured using an ultrasound sonographer at three stages. The first stage was performed on ten (n = 10) healthy men in five different sitting and upright positions. In the second and third experimental model stages, lower limbs loading was applied to 22 participants. Our hypothesis, which was confirmed, was that as a result of increased loads on the participant's back, an intra-articular decrease in the femur-tibia cartilage surface distance would be observed. The accuracy of the created experimental model was improved over its three stages from 30% to 9%. Quantitative model data can help to create a mathematical model of the mechanical effects during the deformation of knee joint bone cartilage and it can also help outline some future tasks: increasing loading weights, enlarging participant groups, performing comparisons of men and women, and performing comparisons of healthy and pathological individuals.
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Affiliation(s)
- Ivan Ivanov
- National Sports Academy “Vassil Levski”, 1700 Sofia, Bulgaria
- Institute of Mechanics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (S.R.); (S.S.)
| | - Sergey Ranchev
- Institute of Mechanics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (S.R.); (S.S.)
| | - Stoyan Stoychev
- Institute of Mechanics, Bulgarian Academy of Sciences, 1113 Sofia, Bulgaria; (S.R.); (S.S.)
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Min H, Rabi Y, Wadhawan A, Bourgeat P, Dowling J, White J, Tchernegovski A, Formanek B, Schuetz M, Mitchell G, Williamson F, Hacking C, Tetsworth K, Schmutz B. Automatic classification of distal radius fracture using a two-stage ensemble deep learning framework. Phys Eng Sci Med 2023; 46:877-886. [PMID: 37103672 DOI: 10.1007/s13246-023-01261-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/16/2023] [Indexed: 04/28/2023]
Abstract
Distal radius fractures (DRFs) are one of the most common types of wrist fracture and can be subdivided into intra- and extra-articular fractures. Compared with extra-articular DRFs which spare the joint surface, intra-articular DRFs extend to the articular surface and can be more difficult to treat. Identification of articular involvement can provide valuable information about the characteristics of fracture patterns. In this study, a two-stage ensemble deep learning framework was proposed to differentiate intra- and extra-articular DRFs automatically on posteroanterior (PA) view wrist X-rays. The framework firstly detects the distal radius region of interest (ROI) using an ensemble model of YOLOv5 networks, which imitates the clinicians' search pattern of zooming in on relevant regions to assess abnormalities. Secondly, an ensemble model of EfficientNet-B3 networks classifies the fractures in the detected ROIs into intra- and extra-articular. The framework achieved an area under the receiver operating characteristic curve of 0.82, an accuracy of 0.81, a true positive rate of 0.83 and a false positive rate of 0.27 (specificity of 0.73) for differentiating intra- from extra-articular DRFs. This study has demonstrated the potential in automatic DRF characterization using deep learning on clinically acquired wrist radiographs and can serve as a baseline for further research in incorporating multi-view information for fracture classification.
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Affiliation(s)
- Hang Min
- CSIRO Australian e-Health Research Centre, Herston, QLD, Australia.
- Ingham Institute for Applied Medical Research, Sydney, NSW, Australia.
- South Western Clinical School, University of New South Wales, Sydney, Australia.
| | - Yousef Rabi
- School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - Ashish Wadhawan
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | | | - Jason Dowling
- CSIRO Australian e-Health Research Centre, Herston, QLD, Australia
- South Western Clinical School, University of New South Wales, Sydney, Australia
- Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW, Australia
- Institute of Medical Physics, The University of Sydney, Sydney, NSW, Australia
- School of Mathematical and Physical Sciences, University of Newcastle, Newcastle, NSW, Australia
| | - Jordy White
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- Medical School, University of Queensland, Brisbane, QLD, Australia
| | | | - Blake Formanek
- Ochsner Clinical School, University of Queensland School of Medicine, Brisbane, QLD, Australia
| | - Michael Schuetz
- School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Jamieson Trauma Institute, Herston, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
- Centre of Biomedical Technologies, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Gary Mitchell
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- Medical School, University of Queensland, Brisbane, QLD, Australia
- Jamieson Trauma Institute, Herston, QLD, Australia
| | - Frances Williamson
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- Medical School, University of Queensland, Brisbane, QLD, Australia
- Jamieson Trauma Institute, Herston, QLD, Australia
| | - Craig Hacking
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- Medical School, University of Queensland, Brisbane, QLD, Australia
| | - Kevin Tetsworth
- Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Beat Schmutz
- School of Mechanical, Medical and Process Engineering, Faculty of Engineering, Queensland University of Technology, Brisbane, QLD, Australia
- Jamieson Trauma Institute, Herston, QLD, Australia
- ARC Training Centre for Multiscale 3D Imaging, Modelling, and Manufacturing, Queensland University of Technology, Brisbane, QLD, Australia
- Centre of Biomedical Technologies, Queensland University of Technology, Kelvin Grove, QLD, Australia
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Cohen A, Claessen T, van den Berg C, Siebelt M, Hagenaars T, Kraan GA, Waarsing JH, Reijman M, Colaris JW. Morphological risk factors for scaphoid fracture: a case-control study. Eur J Trauma Emerg Surg 2023; 49:133-141. [PMID: 36166077 PMCID: PMC9925522 DOI: 10.1007/s00068-022-02101-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/31/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE Most patients with a clinically suspected scaphoid fracture and normal initial radiograph are unnecessarily treated. Previously developed prediction rules using demographic and clinical risk are unable to accurately predict occult fractures. Adding other risk factors could enhance this. Therefore, we aim to explore if there are morphological risk factors of the wrist for sustaining a scaphoid fracture. METHODS We retrospectively included adult patients with a clinically suspected scaphoid fracture between 2013 and 2019 in our case-control study. There were 82 patients with a scaphoid fracture and 158 patients with a wrist contusion. Morphological risk factors were identified using statistical shape modelling (SSM) and linear measurements. Independent wrist shape variations on posteroanterior and lateral radiographs were captured in modes using SSM. Associations between outcomes and a scaphoid fracture were explored using logistic regression and the reliability was assessed. RESULTS Of the 15 posteroanterior modes and 8 lateral modes identified and linear measurements performed, 1 PA mode was associated with a scaphoid fracture (PA mode 4; OR 1.40, CI 1.04-1.93, p = 0.031). We described this mode as an ulna plus and narrower distal radius with more volar tilt and radial inclination. The reliability of the posteroanterior modes and linear measurements was mostly good/excellent and moderate/poor for the lateral modes. CONCLUSION There was one complex wrist shape significantly associated with a scaphoid fracture. Since the association was weak and the shape is difficult to identify radiographs, we believe this morphological risk factor would not enhance identifying occult scaphoid fractures in the future.
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Affiliation(s)
- Abigael Cohen
- Department of Orthopaedic Surgery and Sports Medicine, Erasmus MC University Medical Center, Room Nc-424, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Thomas Claessen
- Department of Neurology, Dijklander Hospital, Maelsonstraat 3, 1624 NP Hoorn, The Netherlands
| | - Corne van den Berg
- Department of Orthopaedic Surgery, Reinier HAGA Orthopaedic Center, Toneellaan 2, 2725 NA Zoetermeer, The Netherlands
| | - Michiel Siebelt
- Department of Orthopaedic Surgery, St. Anna Hospital, Bogardeind 2, 5664 EH Geldrop, The Netherlands
| | - Tjebbe Hagenaars
- Trauma Research Unit, Department of Surgery, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands ,Department of Emergency Medicine, Erasmus MC University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Gerald A. Kraan
- Department of Orthopaedic Surgery, Reinier HAGA Orthopaedic Center, Toneellaan 2, 2725 NA Zoetermeer, The Netherlands
| | - Johannes H. Waarsing
- Department of Orthopaedic Surgery and Sports Medicine, Erasmus MC University Medical Center, Room Nc-424, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Max Reijman
- Department of Orthopaedic Surgery and Sports Medicine, Erasmus MC University Medical Center, Room Nc-424, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Joost W. Colaris
- Department of Orthopaedic Surgery and Sports Medicine, Erasmus MC University Medical Center, Room Nc-424, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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Parks A, Lee AD, Billham J. Recognition and conservative management for a spectrum of sport-related scapholunate interosseous ligament injuries: a case series. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2022; 66:265-281. [PMID: 36818359 PMCID: PMC9914831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
This case series presents four cases of scapholunate interosseous ligament (SLIL) injury. We discuss the process of early recognition and highlight difficulties encountered in current diagnostic and conservative management strategies. The cases profile interdisciplinary management of four scapholunate (SL) injuries that have different clinical presentations and injury mechanisms. Three sport-related SL injuries were managed conservatively by a sport specialist chiropractor and one sport-related case was self-managed. Management strategies included early wrist immobilization, soft tissue manual therapy, low-level laser therapy, proprioceptive and strengthening exercises, and early orthopedic referral. This case series highlights: (1) the spectrum of SL injuries (2) the importance of early specialty referral, (3) the paucity of literature with respect to conservative management of these injuries and (4) the role of manual therapy and rehabilitation professionals as part of the healthcare team in detecting and helping manage these wrist injuries.
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Affiliation(s)
- Andrew Parks
- Division of Graduate Studies, Sports Sciences, Canadian Memorial Chiropractic College
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Eschweiler J, Migliorini F. Reply to Nikolaidis, P.T.; Afonso, J. Comment on "Eschweiler et al. Anatomy, Biomechanics, and Loads of the Wrist Joint. Life 2022, 12, 188". Life (Basel) 2022; 12:1174. [PMID: 36013353 PMCID: PMC9410372 DOI: 10.3390/life12081174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023] Open
Abstract
Pantelis Nikolaidis and Jose Afonso published a letter [...].
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Affiliation(s)
- Jörg Eschweiler
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Pauwelsstraße 30, 52074 Aachen, Germany;
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Nikolaidis PT, Afonso J. Comment on Eschweiler et al. Anatomy, Biomechanics, and Loads of the Wrist Joint. Life 2022, 12, 188. LIFE (BASEL, SWITZERLAND) 2022; 12:life12081166. [PMID: 36013345 PMCID: PMC9410028 DOI: 10.3390/life12081166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 11/16/2022]
Abstract
We have read 'Anatomy, biomechanics and loads of the wrist joint' [...].
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Affiliation(s)
- Pantelis T. Nikolaidis
- School of Health and Caring Sciences, University of West Attica, 12243 Athens, Greece
- Correspondence:
| | - Jose Afonso
- Centre for Research, Education, Innovation and Intervention in Sport, Faculty of Sport, University of Porto, 4200-450 Porto, Portugal;
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Total Wrist Arthroplasty for Posttraumatic Wrist Osteoarthritis: A Cohort Study Comparing Three Indications. Life (Basel) 2022; 12:life12050617. [PMID: 35629285 PMCID: PMC9145948 DOI: 10.3390/life12050617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022] Open
Abstract
Scapholunate ligament ruptures and scaphoid nonunion with consecutive advanced collapse (SLAC and SNAC wrists) as well as intra-articular distal radius fractures (DRF) are prone to cause posttraumatic wrist osteoarthritis. The aim of this study was to compare the outcomes of these indications for total wrist arthroplasty. We included 13, 11, and 8 patients with an overall mean age of 60 ± 9 years in the SLAC, SNAC, and DRF cohort, respectively. After an average follow-up period of 6 ± 3 years, we found no difference between our groups regarding pain levels and functional scores, although these parameters significantly improved compared to preoperative parameters. Complication and revision rates revealed no significant difference. However, significantly higher extension, arc of range of motion values in the flexion-extension, as well as in radial-ulnar deviation plain were detected in the SLAC compared to the DRF group. Finally, TWA proved to show a beneficial performance in all three investigated indications.
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Musculoskeletal Modeling of the Wrist via a Multi Body Simulation. Life (Basel) 2022; 12:life12040581. [PMID: 35455073 PMCID: PMC9031395 DOI: 10.3390/life12040581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 12/23/2022] Open
Abstract
In this study, three different musculoskeletal modeling approaches were compared to each other. The objective was to show the possibilities in the case of a simple mechanical model of the wrist, using a simple multi-body-simulation (MBS) model, and using a more complex and patient-specific adaptable wrist joint MBS model. Musculoskeletal modeling could be a useful alternative, which can be practiced as a non-invasive approach to investigate body motion and internal loads in a wide range of conditions. The goal of this study was the introduction of computer-based modelling of the physiological wrist with (MBS-) models focused on the muscle and joint forces acting on the wrist.
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Eschweiler J, Praster M, Quack V, Li J, Rath B, Hildebrand F, Migliorini F. Comparison of Optimization Strategies for Musculoskeletal Modeling of the Wrist for Therapy Planning in Case of Total Wrist Arthroplasty. Life (Basel) 2022; 12:life12040527. [PMID: 35455018 PMCID: PMC9030398 DOI: 10.3390/life12040527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/16/2022] Open
Abstract
The human wrist joint is an elegant mechanism. The wrist allows the positioning and orienting of the hand to the forearm. The computational modeling of the human hand, especially of the wrist joint, can reveal important information about biomechanical mechanisms and provide the basis for its dysfunction and pathologies. For instance, this could be used for therapy planning in total wrist arthroplasty (TWA). In this study, different optimization methods and sensitivity analyses of anatomical parameters for musculoskeletal modeling were presented. Optimization includes finding the best available value of an objective function, including a variety of different types of objective functions. In the simplest case, optimization consists of maximizing or minimizing a function by systematically choosing input values from within an allowed set and computing the value of the function. Optimization techniques are used in many facets, such as the model building of joints or joint systems such as the wrist. The purpose of this study is to show the variability and influence of the included information for modeling, investigating the biomechanical function and load situation of the joint in representative scenarios. These possibilities to take them into account by an optimization and seem essential for the application of computational modeling to joint pathologies.
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Affiliation(s)
- Jörg Eschweiler
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (M.P.); (V.Q.); (J.L.); (F.H.); (F.M.)
- Correspondence: ; Tel.: +49-(0)-241-8037368
| | - Maximilian Praster
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (M.P.); (V.Q.); (J.L.); (F.H.); (F.M.)
| | - Valentin Quack
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (M.P.); (V.Q.); (J.L.); (F.H.); (F.M.)
| | - Jianzhang Li
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (M.P.); (V.Q.); (J.L.); (F.H.); (F.M.)
| | - Björn Rath
- Department of Orthopaedic Surgery, Klinikum Wels-Grieskirchen, 4600 Wels, Austria;
| | - Frank Hildebrand
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (M.P.); (V.Q.); (J.L.); (F.H.); (F.M.)
| | - Filippo Migliorini
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (M.P.); (V.Q.); (J.L.); (F.H.); (F.M.)
- Department of Orthopaedic and Trauma Surgery, Eifelklinik St. Brigida, 52152 Simmerath, Germany
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