The Journal of Bone and Joint Surgery, Vol 69, Issue 9 1413-1418, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Motion of the wrist after simulated limited intercarpal arthrodeses. An experimental study
DP Douglas, CA Peimer and MP Koniuch
Department of Orthopaedic Surgery, State University of New York, Buffalo 14214.
Seven different types of intercarpal arthrodeses that are commonly used in
clinical practice were simulated in wrists of cadavera by drilling two
nonparallel Kirschner wires across the involved joint that was to be fused.
The changes in radial deviation, ulnar deviation, dorsiflexion, and palmar
flexion, and the arc of motion in two planes (radial plus ulnar deviation
and dorsiflexion plus palmar flexion) were compared with control values for
each specimen and with each of the other arthrodeses. All of the data were
analyzed by calculating the mean and standard error of the changes in these
motions of the wrist as compared with the control values for each wrist.
The statistical significance of the changes was derived by the t test. For
values of t greater than 2.262, the observed mean reductions in the motions
were statistically significant (p = 0.05) in all wrists except those that
had simulated arthrodesis of the lunate-triquetrum or the capitate-hamate
joint. No statistically significant differences were noted between the
effects of arthrodesis of the scaphoid-trapezium-trapezoid,
scaphoid-capitate, and scaphoid-lunate joints on the motions of the wrist.
All arthrodeses except those of the lunate-triquetrum and the
capitate-hamate joint produced a statistically significant decrease in the
total arc of motion; arthrodesis of the capitate-lunate joint produced the
most statistically significant decrease in total arc of motion. In our
opinion, the results of the study suggest that there is limited
justification for arthrodesis of the capitate-hamate joint.(ABSTRACT
TRUNCATED AT 250 WORDS)