title: Biomechanical analysis of capitate shortening with capitate hamate fusion in the treatment of Kienböck's disease.
abstract: The biomechanical effects of surgical treatment options for Kienböck's disease have been compared. However, no study has included a direct analysis of capitate shortening along with capitate-hamate fusion (CSCHF). To investigate the biomechanical effects of CSCHF, a cadaver model of the upper extremity was used to determine radiocarpal articular pressure changes resulting from this procedure using pressure-sensitive film. Ten specimens were tested by placing each in an apparatus that applied load across the radiocarpal joint through the wrist flexor and extensor tendons. Testing was performed in 3 wrist positions (ulnar deviation, radial deviation, and neutral) combined with 3 forearm positions (pronation, supination, and neutral) and neutral flexion/extension. Radioscaphoid, radiolunate, and mean contact pressures in the entire radiocarpal joint were determined for each of the 9 wrist positions, both intact and after surgery. The radioscaphoid mean pressure increased in 6 of 9 positions and was unchanged in 3 positions. The radiolunate mean pressure decreased in 9 of 9 positions. The radiocarpal mean pressure increased in 2 of 9 positions and was unchanged in 7 positions. These data suggests that CSCHF increases radioscaphoid mean pressure, decreases radiolunate mean pressure, and has little effect on radiocarpal mean pressure.
authors.affiliation: Department of Orthopaedic Surgery, Harborview Biomechanics Laboratory, The University of Washington, Seattle, USA.
authors.forename: R W
authors.initials: RW
authors.lastname: Viola
authors.forename: P K
authors.initials: PK
authors.lastname: Kiser
authors.forename: A W
authors.initials: AW
authors.lastname: Bach
authors.forename: D P
authors.initials: DP
authors.lastname: Hanel
authors.forename: A F
authors.initials: AF
authors.lastname: Tencer
mesh_terms: D001174:Arthrodesis; D001696:Biomechanical Phenomena; D002102:Cadaver; D002348:Carpal Bones / Q000601:surgery*; D006801:Humans; D010007:Osteochondritis / Q000503:physiopathology / Q000601:surgery*; D011312:Pressure