title: Surgical Treatments for Scapholunate Advanced Collapse Wrist: Kinematics and Functional Performance.
abstract: OBJECTIVE
  The purpose of this investigation was to compare kinematic motion and functional performance during 2 tasks in patients following 4-corner fusion (4CF) or proximal row carpectomy (PRC) and to compare these data with those from healthy asymptomatic individuals.
  
  
  METHODS
  Twenty men (10 4CFs and 10 PRCs, ages, 43-82 y) were recruited for 3-dimensional wrist motion analysis testing. Kinematic coupling (the ratio of wrist flexion/extension to radial-ulnar deviation), kinematic path length (a measure of total angle distance), clinical measures, and performance measures were collected during 2 tasks: dart throwing and hammering. For each outcome, between-group comparisons employed a 1-way analysis of variance with post hoc analysis using the Fisher least significant difference test.
  
  
  RESULTS
  All clinical measures (flexion-extension, radial-ulnar deviation, and grip strength) were decreased for 4CF and PRC patients compared with healthy subjects. Coupling, kinematic path length, and performance were all significantly reduced in 4CF and PRC patients compared with healthy subjects during both tasks. Reduced coupling and a shorter kinematic path length are indicative of less global and combined wrist motion. There were no differences identified in coupling patterns or performance between the surgical groups for the dart-throwing task. However, in hammering, the kinematic path length and performance (time and total strikes) were worse in 4CF than in PRC.
  
  
  CONCLUSIONS
  Differences in wrist kinematics and performance were identified between the groups. PRC subjects performed better on kinematic and performance variables. As expected, both groups demonstrated decreased wrist kinematic motion and functional performance compared with individuals with normal wrists. These results require confirmation and while they cannot be used to determine the benefits of one procedure over the other, they are an important step in quantifying differences in motion and function between procedures.
  
  
  METHODS
  Therapeutic II.
authors.affiliation: Leon Root Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY. Electronic address: wolffa@hss.edu.
authors.forename: Aviva L
authors.initials: AL
authors.lastname: Wolff
authors.affiliation: Leon Root Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY.
authors.forename: Rohit
authors.initials: R
authors.lastname: Garg
authors.affiliation: Leon Root Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Kraszewski
authors.affiliation: Leon Root Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Hillstrom
authors.affiliation: Leon Root Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY.
authors.forename: Jocelyn F
authors.initials: JF
authors.lastname: Hafer
authors.affiliation: Leon Root Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY.
authors.forename: Sherry I
authors.initials: SI
authors.lastname: Backus
authors.affiliation: Leon Root Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Lenhoff
authors.affiliation: Hand and Upper Extremity Service, Hospital for Special Surgery, New York, NY.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Wolfe
mesh_terms: D000328:Adult; D000368:Aged; D001174:Arthrodesis; D002348:Carpal Bones / Q000601:surgery*; D050824:Carpal Joints / Q000601:surgery*; D016022:Case-Control Studies; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D013647:Task Performance and Analysis; D014955:Wrist Joint / Q000503:physiopathology*
keywords: Wrist; function; kinematics; motion analysis; wrist arthritis