title: The effect of supporting a surgeon's wrist on their hand tremor.
abstract: BACKGROUND
  Operative tremor can greatly influence the outcome of certain, precise, microsurgical operations. Reducing a surgeons tremor may not only improve the operative results but decrease the operative time. Previous studies have only measured uni or bi directional tremor and therefore have been unable to calculate both the overall tremor amplitude and the tremor reduction by resting the wrists.
  
  
  METHODS
  We measured the tremor of 21 neurologically normal volunteers while performing a micromanipulation task, with and without wrist support. Measurements were acquired in three dimensions using three accelerometers attached to the hand, allowing an overall tremor amplitude to be calculated.
  
  
  RESULTS
  Resting the wrist on a gelled surface decreases an individuals tremor by a factor of 2.67 (P = 0).
  
  
  CONCLUSIONS
  Supporting the wrists significantly decreases the amplitude of the tremor. Surgeons should consider using wrist supports when performing parts of operations which necessitate a high degree of accuracy.
authors.affiliation: ENT Department, Queen Elizabeth Hospital, Edgbaston, Birmingham, B15 2TH, UK. chriscoulson@doctors.org.uk
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Coulson
authors.forename: Paul S
authors.initials: PS
authors.lastname: Slack
authors.forename: Xianghong
authors.initials: X
authors.lastname: Ma
mesh_terms: D000328:Adult; D005260:Female; D006225:Hand; D006801:Humans; D008297:Male; D008866:Microsurgery; D011187:Posture; D014202:Tremor / Q000517:prevention & control*; D014955:Wrist Joint