Purpose
To 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.
Methods
Ten 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.
Results
Compared 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).
Conclusions
When performing 4-corner arthrodesis, scaphoid and triquetrum excision may improve
motion at the cost of increased mean radiolunate contact pressure.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Management of the scaphoid during four-corner fusion: a cadaveric study.J Hand Surg. 2003; 28A: 904-909
- Capitolunate arthrodesis with scaphoid and triquetrum excision.J Hand Surg. 2000; 25A: 824-832
- Effect of scaphoid and triquetrum excision on limited arthrodesis of the wrist: a laboratory study.ANZ J Surg. 2002; 72: A39
- Three-corner wrist fusion using memory staples.Techniques in Hand and Upper Extremity Surgery. 2006; 10: 259-264
- The effect of intercarpal joint motion on wrist motion: are there key joints?.Orthopedics. 1995; 18: 727-732
- Functional wrist motion: a biomechanical study.J Hand Surg. 1985; 10A: 39-46
- An in vitro analysis of wrist motion: the effect of limited intercarpal arthrodesis and the contributions of the radiocarpal and midcarpal joints.J Hand Surg. 1988; 13A: 390-395
- Limited wrist arthrodesis: a laboratory study.J Hand Surg. 1987; 12A: 526-529
- Load transfer characteristics of the wrist.J Hand Surg. 1987; 12A: 978-985
- Evaluation of the biomechanical efficacy of limited intercarpal fusions for the treatment of scapholunate dissociation.J Hand Surg. 1990; 15A: 120-128
- The effects of time and light exposure on contact and pressure measurements using Fuji prescale film.Iowa Orthop J. 1997; 17: 64-69
Article info
Publication history
Accepted:
November 24,
2008
Received:
July 15,
2008
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2009 Published by Elsevier Inc.
