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Dart-throwing motion in patients with scapholunate instability: a dynamic four-dimensional computed tomography study
M Garcia-Elias1, X Alomar Serrallach, J Monill Serra
11Institut Kaplan, Hand and Upper Extremity Surgery, Barcelona, Spain.
The Journal of Hand Surgery, European Volume
|April 11, 2013
Summary
Dart-throwing exercises may risk sutures after scapholunate ligament repair. Scapholunate instability causes abnormal carpal bone movement, making these exercises inadvisable without stabilization.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Hand Surgery
Background:
- The dart-throwing motion involves wrist rotation, with normal carpal behavior centered at the midcarpal joint.
- It is unknown if this motion pattern persists with scapholunate ligament tears.
Purpose of the Study:
- To analyze carpal bone behavior during dart-throwing motion in normal wrists versus wrists with scapholunate instability.
- To determine the safety of early dart-throwing exercises following scapholunate ligament repair.
Main Methods:
- Dynamic computed tomography was used to assess carpal kinematics.
- Six normal wrists and six wrists with diagnosed scapholunate instability were studied during dart-throwing motion.
Main Results:
- In normal wrists, the scaphoid and lunate primarily translated, with minimal flexion/extension.
- Wrists with scapholunate instability showed significantly greater radial translation of the scaphoid compared to the lunate (12.8 mm vs. 4.8 mm), creating a scapholunate gap.
Conclusions:
- The altered carpal kinematics in scapholunate instability suggest that dart-throwing exercises could disrupt healing.
- Dart-throwing exercises are not recommended after scapholunate ligament repair unless the joint is surgically stabilized.
