Decoupling the Wrist: A Cadaveric Experiment Examining Wrist Kinematics Following Midcarpal Fusion and Scaphoid Excision Journal Article

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Authors: Nichols, J. A.; Bednar, M. S.; Havey, R. M.; Murray, W. M.
Article Title: Decoupling the Wrist: A Cadaveric Experiment Examining Wrist Kinematics Following Midcarpal Fusion and Scaphoid Excision
Abstract: At the wrist, kinematic coupling (the relationship between flexion-extension and radial-ulnar deviation) facilitates function. Although the midcarpal joint is critical for kinematic coupling, many surgeries, such as four-corner fusion (4CF) and scaphoid-excision four-corner fusion (SE4CF), modify the midcarpal joint. This study examines how 4CF and SE4CF influence kinematic coupling by quantifying wrist axes of rotation. Wrist axes of rotation were quantified in eight cadaveric specimens using an optimization algorithm, which fit a two-revolute joint model to experimental data. In each specimen, data measuring the motion of the third metacarpal relative to the radius was collected for three conditions (nonimpaired, 4CF, SE4CF). The calculated axes of rotation were compared using spherical statistics. The angle between the axes of rotation was used to assess coupling, as the nonimpaired wrist has skew axes (i.e., angle between axes approximately 60 degrees ). Following 4CF and SE4CF, the axes are closer to orthogonal than those of the nonimpaired wrist. The mean angle (+/-95 percent confidence interval) between the axes was 92.6 degrees +/- 25.2 degrees and 99.8 degrees +/- 22.0 degrees for 4CF and SE4CF, respectively. The axes of rotation defined in this study can be used to define joint models, which will facilitate more accurate computational and experimental studies of these procedures.
Journal Title: Journal of applied biomechanics
ISSN: 1065-8483; 1065-8483
Publisher: Unknown  
Journal Place: United States
Date Published: 2016
Start Page: 1
End Page: 29
Language: ENG
DOI/URL:

10.1123/jab.2015-0324
Notes: LR: 20161025; GR: F31 AG041627/AG/NIA NIH HHS/United States; JID: 9315240; OTO: NOTNLM; aheadofprint; SO: J Appl Biomech. 2016 Oct 5:1-29.