title: Multiplanar wrist joint proprioception: The effect of anesthetic blockade of the posterior interosseous nerve or skin envelope surrounding the joint.
abstract: METHODS
  Randomized clinical trial.
  
  
  OBJECTIVE
  Contribution of the posterior interosseous nerve (PIN) and surrounding skin envelope to wrist proprioception is a topic of debate and the primary focus of this research.
  
  
  METHODS
  We performed a double-blinded, placebo control study in which subjects underwent baseline multiplanar testing of wrist proprioception. They were randomized to receive either anesthetic blockade of the PIN within the fourth dorsal compartment, or circumferential topical anesthetic blockade of skin surrounding the wrist. Corresponding opposite wrists underwent placebo intervention with saline injection or inert ultrasound gel. Subjects repeated proprioceptive testing.
  
  
  RESULTS
  Eighty subjects, 45 male and 35 female, mean age 33 years (range, 19-64 years), completed testing. The percentage of measurements falling outside a ±18° range did not differ between pre-treatment and post-treatment PIN blockade or for circumferential skin anesthesia.
  
  
  CONCLUSIONS
  Wrist proprioception appears to be a multifactorial phenomenon. Surgeons may sacrifice the PIN without concern for effect on joint proprioception.
  
  
  METHODS
  Level I.
authors.affiliation: Department of Orthopaedic Surgery and Rehabilitation, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA. Electronic address: ktaylor3@hmc.psu.edu.
authors.forename: Kenneth F
authors.initials: KF
authors.lastname: Taylor
authors.affiliation: Department of Orthopedics and Rehabilitation, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
authors.forename: Vanessa M
authors.initials: VM
authors.lastname: Meyer
authors.affiliation: Military Performance Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA.
authors.forename: Laurel B
authors.initials: LB
authors.lastname: Smith
authors.affiliation: Department of Clinical Investigation, Tripler Army Medical Center, Honolulu, HI, USA.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Lustik
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage; D065527:Brachial Plexus Block; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D008012:Lidocaine / Q000008:administration & dosage; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009824:Ointments; D011434:Proprioception / Q000502:physiology*; D011446:Prospective Studies; D012867:Skin / Q000294:innervation*; D014955:Wrist Joint / Q000294:innervation* / Q000502:physiology*; D055815:Young Adult
chemical_list: D000779:Anesthetics, Local; D009824:Ointments; D008012:Lidocaine
keywords: Joint position sense; Posterior interosseous nerve; Proprioception; Wrist