gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Forearm supination must be avoided during scapholunate ligament-stability exercise programme. A kinetic study in cadavers

Meeting Abstract

  • presenting/speaker Mireia Esplugas - Institut Kaplan Barcelona, Barcelona, Spain
  • Alex Lluch-Bergadà - Institut Kaplan Barcelona, Hospital Vall d´Hebrón-Barcelona, Barcelona, Spain
  • Marc Garcia-Elias - Institut Kaplan Barcelona, Barcelona, Spain
  • Guillem Salvà-Coll - Hospital Son Espases, IBACMA-Mallorca, Mallorca, Spain
  • Nuria Fernandez - Hospital Josep Trueta, Girona, Spain

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSHT19-1111

doi: 10.3205/19ifssh1575, urn:nbn:de:0183-19ifssh15757

Veröffentlicht: 6. Februar 2020

© 2020 Esplugas et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: To analyse if:

1.
forearm rotation modifies the ECRL, ECRB, APL or ECU muscles role on the scapholunate joint stability
2.
an SLL-stability exercise regime can be performed in any forearm rotation.

Materials and Methods: We assessed the changes in the alignment of both, the scaphoid and the triquetrum, in 8 fresh cadaver wrists using an electromagnetic motion tracking device. We isometrically loaded the wrists in three forearm rotations: supination, neutral and pronation. We first individually loaded ECRL, ECRB, APL and ECU. Following, we jointly loaded ECRL, ECRB and APL first and then, ECRL and ECRB. We repeated the experiments after complete SLL sectioning. We applied ANOVA with repeated measures to compare the average degrees of rotation (pronation/supination) and elevation (flexion/extension) sustained by the scaphoid and the triquetrum in each forearm rotation. Significance was set at p<0.05.

Results:

  • The joint isometric ECRL, ECRB loading induces a distal carpal row (DCR) supination in any forearm rotation. Nevertheless, in forearm supination, this DCR supination combines with a scaphoid pronation which changes into scaphoid supination/extension associated to a triquetrum flexion in forearm pronation.
  • The joint isometric APL, ECRL and ECRB loading leads to a DCR and scaphoid supination in any forearm rotation. In neutral forearm rotation, the scaphoid extends while the triquetrum flexes. On the contrary, in forearm pronation/supination the proximal carpal row moves as a block.
  • The isometrical individual ECU loading induces a DCR and a scaphoid bone pronation in all forearm rotations.

Conclusions:

  • Forearm rotation modifies the kinetic carpal muscle control so, an SLL-stability exercise regime cannot be performed in any forearm rotation.
  • The scapholunate joint is only perfectly reduced when the ECRL, ECRB group is loaded in forearm pronation or the ECRL, ECRB and APL group is loaded in neutral forearm rotation.
  • The ECU destabilizes the scapholunate joint in any forearm rotation.