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Jin Bo Tang - One of the best experts on this subject based on the ideXlab platform.
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length changes in scapholunate interosseous ligament with resisted wrist Radial and ulnar inclination
Journal of Hand Surgery (European Volume), 2017Co-Authors: Jun Tan, Jin Bo Tang, Jing Chen, Marc GarciaeliasAbstract:Purpose To investigate the changes in length of the scapholunate interosseous ligament (SLIL) when the wrist is resisting horizontal lateral load and the forearm is in full pronation in vivo . Methods We obtained computed tomography scans of the wrists of 6 volunteers in 3 situations: 0° position (0° extension and 0° ulnar inclination) and full forearm pronation without force, and in the same position but with resisted ulnar and Radial Deviation. Nine zones of 3 subregions of the SLIL were measured and analyzed with computer modeling. Results Changes in length of the palmar SLIL with resisted ulnar Deviation were significantly greater than those without an applied lateral load. In contrast, the changes in length of the dorsal SLIL with resisted Radial Deviation were statistically greater than those in the 0° position without loading. However, no significant differences in the changes in length of the proximal SLIL were found in any of 3 situations, except the dorsal zone with resisted Radial Deviation. Conclusions Application of lateral load has an effect on the separation of the palmar and dorsal insertions of the SLIL. The palmar subregion of the SLIL was more highly strained with wrist-resisted ulnar Deviation. Conversely, the dorsal subregion of the SLIL was under greater tension with wrist-resisted Radial Deviation. Clinical relevance For patients undergoing nonsurgical treatment of SLIL tears, a sudden contraction of ulnar or Radial Deviation agonist muscles may be harmful and contribute to SL instability.
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Changes of ligament lengths at wrist hyperextension in vivo
Chinese Journal of Orthopaedic Trauma, 2012Co-Authors: Jing Chen, Jun Tan, Jin Bo TangAbstract:Objective To investigate changes of ligament lengths with the wrist at the neutral and hyperextended positions in vivo. Methods Six volunteers were enrolled in this study.Their wrists were held in 3 controlled positions:the neutral position of the carpus,hyperextension with Radial Deviation of 0° and hyperextension with Radial Deviation of 10°.We obtained computed tomography scans of the wrists at the 3 positions for each subject for 3-dimensional reconstruction of the carpal and distal radioulnar joint with customized softvare (Mimics 10.0).A total of 9 palmar and dorsal wrist ligaments were measured for the length changes. Results Lengths of the radioscaphocapitate (RSC),long radiolunate (LRL),radioscapholunate (RSL),ulnocapitate (UC),ulnolunate (UL),ulnotriquetral (UT) ligaments,and the dorsal intercarpal (DIC) inserting on the scaphoid ligament at the position of hyperextension with Radial Deviation of 0° were significantly longer than those at the neutral position ( P ＜ 0.05) while lengths of the dorsal-radiocarpal (DRC) ligament and the DIG ligament inserting on the trapezoid decreased significantly ( P ＜0.05).From 0°to 10° of wrist Radial Deviation in hyperextension,the UL,RSC,LRL,DIG inserting on the scaphoid and the trapezoid ligaments decreased significantly in length ( P ＜ 0.05),while UT,UC,RSL and DRC ligaments lengthened significantly (P ＜0.05). Conclusions The RSL,UC and UT ligaments are subjected to higher strain at the position of hyperextension with wrist Radial Deviation of 10°; the RSC,LRL,UL ligaments and dorsal DIC ligament inserting on the scaphoid are subjected to higher strains at the position of hyperextension; the DRC ligament at the neutral position and the DIC ligament inserting on the trapezoid when the wrist is extended are subjected to less tension.Thses findings will help understand the mechanism and range of the injury to the wrist ligaments. Key words: Carpal joints; Ligaments; In vitro
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In Vivo Changes in Contact Regions of the Radiocarpal Joint During Wrist Hyperextension
The Journal of hand surgery, 2012Co-Authors: Jin Bo Tang, Yan Rong ChenAbstract:Purpose Distal radius and scaphoid fractures commonly occur after a fall with the hand outstretched and wrist hyperextended. We investigated contact characteristics of the radiocarpal joint in neutral position, hyperextension, and hyperextension combined with Radial Deviation in vivo. Methods Eight volunteers without a known history of wrist injury were enrolled. We obtained computed tomography scans with 3-dimensional reconstructions of the subjects' right wrists in neutral, hyperextension, and hyperextension with 10° of Radial Deviation. The contact regions of the radiocarpal joint were mapped. The direction and distance of changes in the contact region centers were recorded and analyzed. Results From neutral position to hyperextension, the contact of the scaphoid substantially shifted from the middle to the dorsal part of the articular surface of the radius in 5 of the 8 wrists. With these wrists further deviated Radially, the contact shifted to the surface over the Radial styloid. In the other wrists, the contact of the scaphoid remained in the center of the Radial articular surface. In all wrists, the contact of the radius on the scaphoid shifted from the proximal lateral surface of the scaphoid to the proximal dorsal surface of the scaphoid, and the contact of the radius on the lunate shifted dorsally. Conclusions During wrist hyperextension, the contact of the scaphoid on the distal radius exhibited 2 possible types of changes: either shifting from the mid-portion to the dorsal ridge of the articular surface of the radius or remaining at the center of the articular surface. Combined wrist hyperextension with Radial Deviation caused the scaphoid to contact the radius over the Radial styloid. The contact of the radius on the scaphoid shifted from proximal lateral to proximal dorsal scaphoid, and that on the lunate shifted dorsally. Clinical relevance This study provided in vivo mechanical findings to improve our understanding of the mechanism of hyperextension injuries of carpus.
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In vivo length changes of carpal ligaments of the wrist during dart-throwing motion.
The Journal of hand surgery, 2011Co-Authors: Jin Bo TangAbstract:Purpose The dart-throwing motion is an important movement pattern during most wrist actions. The aim of this study was to investigate length changes in the wrist ligaments in different positions of the dart-throw motion in vivo . Methods We obtained computed tomography scans of the wrists of 6 volunteers at 5 positions of the wrist during the dart-throw motion: 20° of Radial Deviation with 60° of extension; 10° of Radial Deviation with 30° of extension; the neutral position of the carpus; 20° of ulnar Deviation with 30° of flexion; and 40° of ulnar Deviation with 60° of flexion. We reconstructed the 3-dimensional carpal and distal radioulnar joint structures with customized software and computed changes in length of 8 palmar and dorsal wrist ligaments. Results From wrist Radial Deviation with extension to ulnar Deviation with flexion, the radioscaphocapitate, long radiolunate, ulnocapitate, and ulnotriquetral ligaments decreased significantly in length but the dorsal radiocarpal ligament and the dorsal intercarpal (DIC) ligament inserting on the trapezoid lengthened significantly; the ulnolunate ligament and the DIC ligament inserting on the scaphoid were shortest in neutral position. Conclusions At wrist Radial extension, the radioscaphocapitate, long radiolunate, ulnocapitate, and ulnotriquetral ligaments are lengthened and under increased tension. At wrist ulnar flexion, the dorsal radiocarpal ligament and the DIC ligament inserting on the trapezoid are lengthened and under increased tension. The ulnolunate ligament and the DIC ligament inserting on the scaphoid are the shortest and under the least tension in neutral position. These findings will help us understand the biomechanics of the carpus during the dart-throwing motion.
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Scaphoid and lunate movement in different ranges of carpal radioulnar Deviation.
The Journal of hand surgery, 2010Co-Authors: Jin Bo Tang, Ren Guo XieAbstract:Purpose We aimed to investigate scaphoid and lunate movement in Radial Deviation and in slight and moderate ulnar Deviation ranges in vivo. Methods We obtained computed tomography scans of the right wrists from 20° Radial Deviation to 40° ulnar Deviation in 20° increments in 6 volunteers. The 3-dimensional bony structures of the wrist, including the distal radius and ulna, were reconstructed with customized software. The changes in position of the scaphoid and lunate along flexion–extension motion (FEM), radioulnar Deviation (RUD), and supination–pronation axes in 3 parts—Radial Deviation and slight and moderate ulnar Deviation—of the carpal RUD were calculated and analyzed. Results During carpal RUD, scaphoid and lunate motion along 3 axes—FEM, RUD, and supination–pronation—were the greatest in the middle third of the measured RUD (from neutral position to 20° ulnar Deviation) and the smallest in Radial Deviation. Scaphoid motion along the FEM, RUD, and supination–pronation axes in the middle third was about half that in the entire motion range. In the middle motion range, lunate movement along the FEM and RUD axes was also the greatest. Conclusions During carpal RUD, the greatest scaphoid and lunate movement occurs in the middle of the arc—slight ulnar Deviation—which the wrist frequently adopts to accomplish major hand actions. At Radial Deviation, scaphoid and lunate motion is the smallest.
Robert W Wysocki - One of the best experts on this subject based on the ideXlab platform.
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clinical outcomes of proximal row carpectomy versus four corner arthrodesis for post traumatic wrist arthropathy a systematic review
Journal of Hand Surgery (European Volume), 2015Co-Authors: Bryan M Saltzman, Jonathan M Frank, William Slikker, John J Fernandez, Mark S Cohen, Robert W WysockiAbstract:We conducted a systematic review of studies reporting clinical outcomes after proximal row carpectomy or to four-corner arthrodesis for scaphoid non-union advanced collapse or scapholunate advanced collapse arthritis. Seven studies (Levels I-III; 240 patients, 242 wrists) were evaluated. Significantly different post-operative values were as follows for four-corner arthrodesis versus proximal row carpectomy groups: wrist extension, 39 (SD 11o) versus 43 (SD 11o); wrist flexion, 32 (SD 10o) versus 36 (SD 11o); flexion-extension arc, 62 (SD 14o) versus 75 (SD 10o); Radial Deviation, 14 (SD 5o) versus 10 (SD 5o); hand grip strength as a percentage of contralateral side, 74% (SD 13) versus 67% (SD 16); overall complication rate, 29% versus 14%. The most common post-operative complications were non-union (grouped incidence, 7%) after four-corner arthrodesis and synovitis and clinically significant oedema (3.1%) after proximal row carpectomy. Radial Deviation and post-operative hand grip strength (as a percentage of the contralateral side) were significantly better after four-corner arthrodesis. Four-corner arthrodesis gave significantly greater post-operative Radial Deviation and grip strength as a percentage of the opposite side. Wrist flexion, extension, and the flexion-extension arc were better after proximal row carpectomy, which also had a lower overall complication rate.
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clinical outcomes of proximal row carpectomy versus four corner arthrodesis for post traumatic wrist arthropathy a systematic review
Journal of Hand Surgery (European Volume), 2015Co-Authors: Bryan M Saltzman, Jonathan M Frank, William Slikker, John J Fernandez, Mark S Cohen, Robert W WysockiAbstract:We conducted a systematic review of studies reporting clinical outcomes after proximal row carpectomy or to four-corner arthrodesis for scaphoid non-union advanced collapse or scapholunate advanced collapse arthritis. Seven studies (Levels I–III; 240 patients, 242 wrists) were evaluated. Significantly different post-operative values were as follows for four-corner arthrodesis versus proximal row carpectomy groups: wrist extension, 39 (SD 11o) versus 43 (SD 11o); wrist flexion, 32 (SD 10o) versus 36 (SD 11o); flexion-extension arc, 62 (SD 14o) versus 75 (SD 10o); Radial Deviation, 14 (SD 5o) versus 10 (SD 5o); hand grip strength as a percentage of contralateral side, 74% (SD 13) versus 67% (SD 16); overall complication rate, 29% versus 14%. The most common post-operative complications were non-union (grouped incidence, 7%) after four-corner arthrodesis and synovitis and clinically significant oedema (3.1%) after proximal row carpectomy. Radial Deviation and post-operative hand grip strength (as a percentag...
Nadja Ehmke - One of the best experts on this subject based on the ideXlab platform.
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TGDS pathogenic variants cause Catel-Manzke syndrome without hyperphalangy
American journal of medical genetics. Part A, 2019Co-Authors: Felix Boschann, Kyra E. Stuurman, Christiaan De Bruin, Marjon Van Slegtenhorst, Hermine A. Van Duyvenvoorde, S.g. Kant, Nadja EhmkeAbstract:Catel-Manzke syndrome, also known as micrognathia-digital-syndrome, is a rare autosomal recessive disorder characterized by the combination of the two cardinal features Pierre-Robin sequence and bilateral hyperphalangy leading to ulnar clinodactyly (ulnar curvature of the phalanges) and Radial Deviation (Radial angulation at the metacarpophalangeal joint) of the index fingers. Individuals without one of these major hallmarks or with additional hand malformations have been described as atypical or Catel-Manzke-like syndrome. Biallelic TGDS pathogenic variants have thus far been detected in eight individuals with typical Catel-Manzke syndrome and in one fetus with additional features. Here we report on two individuals with TGDS pathogenic variants who presented with mild Radial Deviation and ulnar clinodactyly of the index fingers but without radiologic signs of hyperphalangy. Furthermore, both individuals have disproportionate short stature, a feature that has not yet been associated with Catel-Manzke syndrome. Our data broaden the phenotypic spectrum of TGDS-associated Catel-Manzke syndrome and expand the indication for diagnostic testing.
Jun Tan - One of the best experts on this subject based on the ideXlab platform.
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length changes in scapholunate interosseous ligament with resisted wrist Radial and ulnar inclination
Journal of Hand Surgery (European Volume), 2017Co-Authors: Jun Tan, Jin Bo Tang, Jing Chen, Marc GarciaeliasAbstract:Purpose To investigate the changes in length of the scapholunate interosseous ligament (SLIL) when the wrist is resisting horizontal lateral load and the forearm is in full pronation in vivo . Methods We obtained computed tomography scans of the wrists of 6 volunteers in 3 situations: 0° position (0° extension and 0° ulnar inclination) and full forearm pronation without force, and in the same position but with resisted ulnar and Radial Deviation. Nine zones of 3 subregions of the SLIL were measured and analyzed with computer modeling. Results Changes in length of the palmar SLIL with resisted ulnar Deviation were significantly greater than those without an applied lateral load. In contrast, the changes in length of the dorsal SLIL with resisted Radial Deviation were statistically greater than those in the 0° position without loading. However, no significant differences in the changes in length of the proximal SLIL were found in any of 3 situations, except the dorsal zone with resisted Radial Deviation. Conclusions Application of lateral load has an effect on the separation of the palmar and dorsal insertions of the SLIL. The palmar subregion of the SLIL was more highly strained with wrist-resisted ulnar Deviation. Conversely, the dorsal subregion of the SLIL was under greater tension with wrist-resisted Radial Deviation. Clinical relevance For patients undergoing nonsurgical treatment of SLIL tears, a sudden contraction of ulnar or Radial Deviation agonist muscles may be harmful and contribute to SL instability.
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In vivo length changes of wrist ligaments at full wrist extension
The Journal of hand surgery European volume, 2013Co-Authors: Jun Tan, Jing Chen, J. B. TangAbstract:The aim of this study was to investigate the length changes of carpal ligaments when loaded in full extension in vivo. We obtained computed tomography scans of the right wrists in three positions for six volunteers: neutral; 75° extension; and 75° extension with a further 10° of Radial Deviation. Nine ligaments were measured and analysed with computer modelling. The results showed that the radioscaphocapitate, long radiolunate, and ulnolunate ligaments lengthened the most at full wrist extension, suggesting that they were under greatest load. The radioscapholunate, ulnocapitate, and ulnotriquetral ligaments lengthened further with the addition of wrist Radial Deviation. At full extension, the dorsal intercarpal ligament inserting on the scaphoid was lengthened. The dorsal radiocarpal and dorsal intercarpal ligaments inserting on the trapezoid were shortened, suggesting reduced loading. In conclusion, a number of volar carpal ligaments lengthened significantly in full wrist extension and the ulnar carpal l...
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Changes of ligament lengths at wrist hyperextension in vivo
Chinese Journal of Orthopaedic Trauma, 2012Co-Authors: Jing Chen, Jun Tan, Jin Bo TangAbstract:Objective To investigate changes of ligament lengths with the wrist at the neutral and hyperextended positions in vivo. Methods Six volunteers were enrolled in this study.Their wrists were held in 3 controlled positions:the neutral position of the carpus,hyperextension with Radial Deviation of 0° and hyperextension with Radial Deviation of 10°.We obtained computed tomography scans of the wrists at the 3 positions for each subject for 3-dimensional reconstruction of the carpal and distal radioulnar joint with customized softvare (Mimics 10.0).A total of 9 palmar and dorsal wrist ligaments were measured for the length changes. Results Lengths of the radioscaphocapitate (RSC),long radiolunate (LRL),radioscapholunate (RSL),ulnocapitate (UC),ulnolunate (UL),ulnotriquetral (UT) ligaments,and the dorsal intercarpal (DIC) inserting on the scaphoid ligament at the position of hyperextension with Radial Deviation of 0° were significantly longer than those at the neutral position ( P ＜ 0.05) while lengths of the dorsal-radiocarpal (DRC) ligament and the DIG ligament inserting on the trapezoid decreased significantly ( P ＜0.05).From 0°to 10° of wrist Radial Deviation in hyperextension,the UL,RSC,LRL,DIG inserting on the scaphoid and the trapezoid ligaments decreased significantly in length ( P ＜ 0.05),while UT,UC,RSL and DRC ligaments lengthened significantly (P ＜0.05). Conclusions The RSL,UC and UT ligaments are subjected to higher strain at the position of hyperextension with wrist Radial Deviation of 10°; the RSC,LRL,UL ligaments and dorsal DIC ligament inserting on the scaphoid are subjected to higher strains at the position of hyperextension; the DRC ligament at the neutral position and the DIC ligament inserting on the trapezoid when the wrist is extended are subjected to less tension.Thses findings will help understand the mechanism and range of the injury to the wrist ligaments. Key words: Carpal joints; Ligaments; In vitro
Bryan M Saltzman - One of the best experts on this subject based on the ideXlab platform.
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clinical outcomes of proximal row carpectomy versus four corner arthrodesis for post traumatic wrist arthropathy a systematic review
Journal of Hand Surgery (European Volume), 2015Co-Authors: Bryan M Saltzman, Jonathan M Frank, William Slikker, John J Fernandez, Mark S Cohen, Robert W WysockiAbstract:We conducted a systematic review of studies reporting clinical outcomes after proximal row carpectomy or to four-corner arthrodesis for scaphoid non-union advanced collapse or scapholunate advanced collapse arthritis. Seven studies (Levels I-III; 240 patients, 242 wrists) were evaluated. Significantly different post-operative values were as follows for four-corner arthrodesis versus proximal row carpectomy groups: wrist extension, 39 (SD 11o) versus 43 (SD 11o); wrist flexion, 32 (SD 10o) versus 36 (SD 11o); flexion-extension arc, 62 (SD 14o) versus 75 (SD 10o); Radial Deviation, 14 (SD 5o) versus 10 (SD 5o); hand grip strength as a percentage of contralateral side, 74% (SD 13) versus 67% (SD 16); overall complication rate, 29% versus 14%. The most common post-operative complications were non-union (grouped incidence, 7%) after four-corner arthrodesis and synovitis and clinically significant oedema (3.1%) after proximal row carpectomy. Radial Deviation and post-operative hand grip strength (as a percentage of the contralateral side) were significantly better after four-corner arthrodesis. Four-corner arthrodesis gave significantly greater post-operative Radial Deviation and grip strength as a percentage of the opposite side. Wrist flexion, extension, and the flexion-extension arc were better after proximal row carpectomy, which also had a lower overall complication rate.
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clinical outcomes of proximal row carpectomy versus four corner arthrodesis for post traumatic wrist arthropathy a systematic review
Journal of Hand Surgery (European Volume), 2015Co-Authors: Bryan M Saltzman, Jonathan M Frank, William Slikker, John J Fernandez, Mark S Cohen, Robert W WysockiAbstract:We conducted a systematic review of studies reporting clinical outcomes after proximal row carpectomy or to four-corner arthrodesis for scaphoid non-union advanced collapse or scapholunate advanced collapse arthritis. Seven studies (Levels I–III; 240 patients, 242 wrists) were evaluated. Significantly different post-operative values were as follows for four-corner arthrodesis versus proximal row carpectomy groups: wrist extension, 39 (SD 11o) versus 43 (SD 11o); wrist flexion, 32 (SD 10o) versus 36 (SD 11o); flexion-extension arc, 62 (SD 14o) versus 75 (SD 10o); Radial Deviation, 14 (SD 5o) versus 10 (SD 5o); hand grip strength as a percentage of contralateral side, 74% (SD 13) versus 67% (SD 16); overall complication rate, 29% versus 14%. The most common post-operative complications were non-union (grouped incidence, 7%) after four-corner arthrodesis and synovitis and clinically significant oedema (3.1%) after proximal row carpectomy. Radial Deviation and post-operative hand grip strength (as a percentag...
