Bhardwaj Praveen, Nayak Saumyakumar S, Kiswar Asif M, Sabapathy S Raja
Department of Plastic, Hand, Burns and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India.
Indian J Plast Surg. 2011 Jan;44(1):55-8. doi: 10.4103/0970-0358.81440.
Grip strength after wrist arthrodesis is reported to be significantly less than normal. One of the reasons suggested for this decrease in grip strength is that the arthrodesis was performed in a suboptimal position. However, there is no consensus on the ideal position of wrist fusion. There is a paucity of studies evaluating the effect of various fixed positions of the wrist on grip strength and therefore, there is no guide regarding the ideal position of wrist fusion. The authors' aim was to determine the grip strength in various fixed positions of the wrist and subsequently to find out in which position of wrist fusion the grip strength would be maximal.
One hundred healthy adults participated in the study. For the purpose of this study, the authors constructed splints to hold the wrist in five different fixed positions: 45, 30 and 15 degrees of wrist extension, neutral and 30 degrees of wrist flexion. The grip strength in all the participants was measured bilaterally, first without a splint and then with each splint sequentially.
The average grip strength without the splint was 34.3 kg for right and 32.3 kg for the left hand. Grip strength decreased by 19-25% when the wrist was splinted. The maximum average grip strength with a splint on was recorded at 45 degrees of extension (27.9 kg for right and 26.3 kg for left side). There was a gradual increase in the grip strength with increase in wrist extension but the difference was not statistically significant (P = 0.29). The grip strength was significantly less in flexed position of the wrist (P < 0.001).
据报道，腕关节融合术后的握力明显低于正常水平。握力下降的一个原因是关节融合术是在非最佳位置进行的。然而，关于腕关节融合的理想位置尚无共识。评估腕关节不同固定位置对握力影响的研究很少，因此，对于腕关节融合的理想位置没有指导意见。作者的目的是确定腕关节在不同固定位置时的握力，随后找出腕关节融合在哪个位置时握力最大。
100名健康成年人参与了这项研究。为了本研究的目的，作者制作了夹板，将腕关节固定在五个不同位置：腕关节伸展45度、30度和15度、中立位以及腕关节屈曲30度。对所有参与者双侧测量握力，首先不使用夹板，然后依次使用每个夹板测量。
不使用夹板时，右手平均握力为34.3千克，左手为32.3千克。使用夹板时，握力下降了19%至25%。夹板固定在伸展45度时记录到最大平均握力（右侧为27.9千克，左侧为26.3千克）。随着腕关节伸展增加，握力逐渐增加，但差异无统计学意义（P = 0.29）。腕关节屈曲位时握力明显较低（P < 0.001）。
