Rehabilitation for scapholunate injury: Application of scientific and clinical evidence to practice.
In this article, the development of a rehabilitation approach is describe using scapholunate injury as a model. We demonstrate how scientific and clinical evidence is applied to a treatment paradigm and modified based on emerging evidence. Role of the scapholunate interosseous ligament within the pathomechanics of the carpus, along with the progression of pathology, and specific rehabilitation algorithms tailored to the stage of injury. We review the recent and current evidence on the kinematics of wrist motion during functional activity, role of the muscles in providing dynamic stability of the carpus, and basic science of proprioception. Key relevant findings in each of these inter-related areas are highlighted to demonstrate how together they form the basis for current wrist rehabilitation. Finally, we make recommendations for future research to further test the efficacy of these approaches in improving functional outcomes.
Leon Root, MD Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY, USA. Electronic address: wolffa@hss.edu.
Aviva L
AL
Wolff
Hand and Upper Extremity Service, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA.
Scott W
SW
Wolfe
D019317:Evidence-Based Medicine; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D015601:Injury Severity Score; D007537:Isometric Contraction / Q000502:physiology; D012667:Lunate Bone / Q000293:injuries*; D008297:Male; D010147:Pain Measurement; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D021361:Scaphoid Bone / Q000293:injuries*; D014954:Wrist Injuries / Q000175:diagnosis / Q000534:rehabilitation*
Dart-thrower's motion; Rehabilitation; Scapholunate injury; Scapholunate interosseous ligament