Rust Philippa A, Manojlovich Larissa M, Wallace Robert
1 Hand Surgery Unit, St John's Hospital, Livingston, UK.
2 Department of Anatomy, University of Edinburgh, Edinburgh, UK.
J Hand Surg Eur Vol. 2018 Sep;43(7):718-722. doi: 10.1177/1753193418783330. Epub 2018 Jun 27.
Dart thrower's motion is the functional coupled movement of the wrist from radial extension to ulnar flexion. The aim of this study was to evaluate dart thrower's motion following three surgeries: radioscapholunate fusion, four-corner fusion and proximal row carpectomy. Six fresh-frozen cadaver forearms were dissected. Sequential loading of tendons resulted in radial extension and ulnar flexion allowing dart thrower's motion measurements at end range before and then again after each surgery. After radioscapholunate fusion, 74% of both radial extension and ulnar flexion were maintained. After four-corner fusion, radial extension decreased to 53% and ulnar flexion to 84% of control motion. Proximal row carpectomy did not statistically significantly alter radial extension, but decreased ulnar flexion to 87%. We found that dart thrower's motion is well maintained in three of these commonly used surgical treatments. These results may aid surgeons in managing patients by providing comparative functional movement following these procedures.
飞镖投掷者动作是手腕从桡侧伸展到尺侧屈曲的功能性耦合运动。本研究的目的是评估在进行三种手术后的飞镖投掷者动作：桡舟月融合术、四角融合术和近排腕骨切除术。对六个新鲜冷冻的尸体前臂进行了解剖。对肌腱进行顺序加载，导致桡侧伸展和尺侧屈曲，从而在每次手术前后的最终范围内测量飞镖投掷者动作。桡舟月融合术后，桡侧伸展和尺侧屈曲均保持了74%。四角融合术后，桡侧伸展降至对照动作的53%，尺侧屈曲降至84%。近排腕骨切除术在统计学上未显著改变桡侧伸展，但尺侧屈曲降至87%。我们发现，在这些常用的手术治疗中，有三种手术能很好地保持飞镖投掷者动作。这些结果可为外科医生在这些手术之后提供比较性的功能运动情况，从而有助于他们对患者进行管理。
