Orthotic intervention incorporating the dart-thrower's motion as part of conservative management guidelines for treatment of scapholunate injury.
METHODS
Case series.


BACKGROUND
This paper describes conservative guidelines for the management of scapho-lunate interosseous ligament (SLIL) injury including fabrication of an orthosis that restricts active wrist movement to the dart-throwers (DTM) plane.


OBJECTIVE
The dart throwers' orthosis (DTO) was designed as a response to biomechanical studies suggesting that restraining motion to the DTM would off-load a deficient SLIL.


METHODS
After six weeks of wearing the DTO, the 5 patients in this case series initiated an exercise program that incorporated wrist proprioceptive training and specific muscle strengthening.


CONCLUSIONS
The DTO was designed to incorporate controlled movement in order to better integrate the secondary wrist stabilizers in wrists that had a deficient SLIL. The orthosis and the exercise program harnessed proprioceptive influences using active motion within the DTM plane, and stimulated mechanoreceptors so as to enhance stability.


RESULTS
All patients demonstrated improvement in subjective and objective outcomes including self-reported pain and function.


CONCLUSIONS
Orthotic intervention that controls motion within the DTM, combined with an appropriate proprioceptive rehabilitation program, may provide a viable conservative treatment option for patients with a similar clinical presentation.


METHODS
4.
Anderson Hand Therapy, The Avenue Physiotherapy Centre, Windsor, Victoria, Australia; Melbourne Orthopaedic Group, Windsor, Victoria, Australia. Electronic address: hamish@andersonhandtherapy.com.au.
Hamish
H
Anderson
Melbourne Orthopaedic Group, Windsor, Victoria, Australia.
Greg
G
Hoy
D000328:Adult; D050824:Carpal Joints / Q000293:injuries*; D002648:Child; D000072700:Conservative Treatment / Q000295:instrumentation / Q000592:standards*; D004867:Equipment Design; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007593:Joint Instability / Q000517:prevention & control / Q000534:rehabilitation; D008023:Ligaments, Articular / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016059:Range of Motion, Articular; D018570:Risk Assessment; D012494:Sampling Studies; D013165:Splints / Q000706:statistics & numerical data*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
Dart-throwing motion; Orthosis; Proprioception; Scapholunate ligaments; Therapy guidelines