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Carpal height and postoperative strength after proximal row carpectomy or four-corner arthrodesis: Clinical, anatomical and biomechanical study.
Hand Surg Rehabil. 2016 04; 35(2):100-6.HS

Abstract

Proximal row carpectomy (PRC) and four-corner arthrodesis (4CA) are the two most commonly performed surgical procedures to treat wrist arthritis. Postoperative strength is one of the criteria for choosing between the two techniques. Some authors believe that strength is correlated with residual carpal height. The goal of this study was to determine if postoperative carpal height was predictive of postoperative strength. This study consisted of two parts: a clinical evaluation of grip strength after 4CA or PRC; anatomical and radiological measurements of carpal height before and after 4CA or PRC. Grip strength was better preserved after PRC (87.5%) than after 4CA (76.1%), when expressed relative to the opposite hand (P=0.053). There was a significant decrease in carpal height for the PRC group with a Youm's index of 0.37 versus 0.50 for the 4CA group (P<0.0001). Our clinical results and analysis of the literature indicate that 4CA is not superior to PRC when it comes to grip strength, whereas carpal height is significantly decreased after PRC. The decreased tendon excursion after PRC is balanced by an increase in joint stresses after 4CA.

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Authors+Show Affiliations

Laronde P
Service d'orthopédie B, hôpital Roger-Salengro, rue Emile-Laine, 59037 Lille, France; Laboratoire d'anatomie, faculté de médecine de Lille, 1, place de Verdun, 59045 Lille cedex, France. Electronic address: pascale.laronde@gmail.com.
Christiaens N
Service d'orthopédie B, hôpital Roger-Salengro, rue Emile-Laine, 59037 Lille, France.
Aumar A
Service d'orthopédie B, hôpital Roger-Salengro, rue Emile-Laine, 59037 Lille, France; Laboratoire d'anatomie, faculté de médecine de Lille, 1, place de Verdun, 59045 Lille cedex, France.
Chantelot C
Service d'orthopédie B, hôpital Roger-Salengro, rue Emile-Laine, 59037 Lille, France; Service de traumatologie, hôpital Roger-Salengro, rue Emile-Laine, 59037 Lille, France.
Fontaine C
Service d'orthopédie B, hôpital Roger-Salengro, rue Emile-Laine, 59037 Lille, France; Laboratoire d'anatomie, faculté de médecine de Lille, 1, place de Verdun, 59045 Lille cedex, France; Laboratoire d'automatique, de mécanique et d'informatique industrielle et humaine LAMIH, université de Valenciennes et du Hainaut-Cambrésis, Le Mont Houy, 59313 Valenciennes cedex, France.

MeSH

AdultAgedArthritisArthrodesisBiomechanical PhenomenaCarpal BonesFemaleHand StrengthHumansMaleMiddle AgedRange of Motion, ArticularScaphoid BoneTreatment OutcomeWrist JointYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27117123

Citation

Laronde, Pascale, et al. "Carpal Height and Postoperative Strength After Proximal Row Carpectomy or Four-corner Arthrodesis: Clinical, Anatomical and Biomechanical Study." Hand Surgery & Rehabilitation, vol. 35, no. 2, 2016, pp. 100-6.
Laronde P, Christiaens N, Aumar A, et al. Carpal height and postoperative strength after proximal row carpectomy or four-corner arthrodesis: Clinical, anatomical and biomechanical study. Hand Surg Rehabil. 2016;35(2):100-6.
Laronde, P., Christiaens, N., Aumar, A., Chantelot, C., & Fontaine, C. (2016). Carpal height and postoperative strength after proximal row carpectomy or four-corner arthrodesis: Clinical, anatomical and biomechanical study. Hand Surgery & Rehabilitation, 35(2), 100-6. https://doi.org/10.1016/j.hansur.2016.01.003
Laronde P, et al. Carpal Height and Postoperative Strength After Proximal Row Carpectomy or Four-corner Arthrodesis: Clinical, Anatomical and Biomechanical Study. Hand Surg Rehabil. 2016;35(2):100-6. PubMed PMID: 27117123.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Carpal height and postoperative strength after proximal row carpectomy or four-corner arthrodesis: Clinical, anatomical and biomechanical study. AU - Laronde,Pascale, AU - Christiaens,Nicolas, AU - Aumar,Aurélien, AU - Chantelot,Christophe, AU - Fontaine,Christian, Y1 - 2016/03/17/ PY - 2015/09/02/received PY - 2015/12/29/revised PY - 2016/01/10/accepted PY - 2016/4/28/entrez PY - 2016/4/28/pubmed PY - 2018/8/2/medline KW - Arthrodèse des quatre os KW - Carpal height KW - Excursion tendineuse KW - Force de poigne KW - Four-corner arthrodesis KW - Grip strength KW - Hauteur du carpe KW - Proximal row carpectomy KW - Résection de la rangée proximale du carpe KW - Tendon excursion SP - 100 EP - 6 JF - Hand surgery & rehabilitation JO - Hand Surg Rehabil VL - 35 IS - 2 N2 - Proximal row carpectomy (PRC) and four-corner arthrodesis (4CA) are the two most commonly performed surgical procedures to treat wrist arthritis. Postoperative strength is one of the criteria for choosing between the two techniques. Some authors believe that strength is correlated with residual carpal height. The goal of this study was to determine if postoperative carpal height was predictive of postoperative strength. This study consisted of two parts: a clinical evaluation of grip strength after 4CA or PRC; anatomical and radiological measurements of carpal height before and after 4CA or PRC. Grip strength was better preserved after PRC (87.5%) than after 4CA (76.1%), when expressed relative to the opposite hand (P=0.053). There was a significant decrease in carpal height for the PRC group with a Youm's index of 0.37 versus 0.50 for the 4CA group (P<0.0001). Our clinical results and analysis of the literature indicate that 4CA is not superior to PRC when it comes to grip strength, whereas carpal height is significantly decreased after PRC. The decreased tendon excursion after PRC is balanced by an increase in joint stresses after 4CA. SN - 2468-1210 UR - https://www.unboundmedicine.com/medline/citation/27117123/Carpal_height_and_postoperative_strength_after_proximal_row_carpectomy_or_four_corner_arthrodesis:_Clinical_anatomical_and_biomechanical_study_ DB - PRIME DP - Unbound Medicine ER -