| Popis: |
Kienbock's disease causes degeneration of the lunate bone in the wrist leading to pain and reduced function of the joint. Clinical studies have found a new technique, radial core decompression (RCD) to be clinically effective in improving early stage Kienbock's disease. However, there have been no biomechanical studies characterizing the changes in wrist kinematics following the RCD procedure. The purpose of this study is to determine the changes in lunate and scaphoid motions following the RCD procedure.This study employs an electromagnetic 3-dimensional tracking system, Polhemus 3-SPACE, to measure the motions of the lunate, scaphoid, and third metacarpal in four cadaveric specimens. Specimens were partially dissected and sutures were attached to five major tendons used for wrist motion. Motion sensors were installed on the lunate,scaphoid, and third metacarpal, and a source was installed on the radius. CT scans were taken of the specimens and digitally reconstructed to determine the relationships between bony coordinate systems and sensor coordinate systems. Wrist specimens were installed in a custom test rig and weights were attached to the sutured tendons to simulate muscle tone. The wrists were passively moved through Flexion/Extension and Radial/Ulnar Deviation motion cycles with motion data collected at various positions through the cycles.After collecting motion data for intact wrist specimens, RCD procedures were performed and motion data was collected for the post-RCD wrists. Joint Coordinate Systems were developed for each specimen and test results were calculated as flexion, ulnar deviation, and pronation angles for each position of Flexion/Extension and Radial/Ulnar Deviation motion. Results were normalized so that statistical comparisons could be performed.Results shows statistically signicant differences in wrist motion following the RCD technique. However, most of these differences were less than 4 degrees. This suggests there are minimal clinically-relevant changes in wrist kinematics following the RCD technique. |
