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Fulltext Rare combination of seven fractures in the same forearm and wrist

Pan KL, Masbah O, Razak M

Med J Malaysia, 2000 Jun;55(2):268-70.
PMID: 19839159

A rare combination of a segmental ulnar fracture with fracture dislocation of the head of the radius and intraarticular fracture of the distal radius concomitant with an ipsilateral scaphoid, lunate and coronoid process fractures is presented. The mechanism of injury could possibly be a tremendous impact on the outstretched hand with a dorsiflexed wrist, fracturing the carpal bones and the distal radius. Transmitted axial forces on the ulna in a pronating forearm resulted in the other fractures. To the best of our knowledge, no such case has been reported. Open reduction with screw fixation of the scaphoid, plating of the proximal ulna and Kirschner wiring of the distal radius and radial head dislocation were done.

Matched MeSH terms: Wrist Injuries*
Fulltext Functional Outcome after Treatment of Aggressive Tumours in the Distal Radius: Comparison between Reconstruction using Proximal Fibular Graft and Wrist Fusion

Choo CY, Mat-Saad AM, Wan-Azman WS, Wan Z, Nor-Azman MZ, Yahaya S, et al.

Malays Orthop J, 2018 Nov;12(3):19-23.
PMID: 30555642 MyJurnal DOI: 10.5704/MOJ.1811.004

Introduction: Restoration of a functional hand is the ultimate goal following a distal radius tumour resection. The early outcomes of mobile wrist reconstruction are satisfactory; however, long-term results are unpredictable due to late wrist instability and degenerative arthritis. Our aim is to compare mobile wrist reconstruction with wrist fusion (pan-carpal fusion) in our cohort of patients. Materials and Methods: A retrospective cohort study was performed for functional outcomes of all patients who underwent resection for distal radius tumour and treated with either fusion or reconstruction of the wrist in a single institution from years 2000-2013 with a minimum of three years follow-up. Results: Eleven patients were included in the study, six of whom had wrist reconstruction with proximal fibula graft and the remaining five wrist fusion, with a mean follow-up of 6.3 years. The mean Musculoskeletal Tumour Society (MSTS) score was 82.78%, ranging from 70% to 93.3%. Average grip strength compared to the normal contralateral hand was 60.0% for total wrist fusion, which was better than wrist reconstruction with 58.07%. There was no difference in the functional outcome between fusion and mobile reconstruction in our study. Osteoarthritis changes and subluxation of the wrist joint were the most common findings in the long-term follow-up for this group. Conclusion: There was no difference in the functional outcome of the long-term follow-up between the two groups.

Matched MeSH terms: Wrist; Wrist Joint
Fulltext Carpal tunnel syndrome in pregnancy : is there really oedema in the carpal tunnel?

Mohamed Faizal Sikkandar, Shalimar Abdullah, Rajesh Singh, Parminder Singh Gill, Nur Azuatul Akmal Kamaludin, Tan Jin Aun, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):191-195.
MyJurnal

Introduction: Compression of the median nerve in pregnancy is thought to be due to fluid retention within the carpal tunnel space. We aim to discover the cause of carpal tunnel syndrome (CTS) in pregnancy using high resonance ul- trasonography. Methods: This is a cross-sectional study where obstetric patients were screened for CTS and subjected to a non invasive ultrasonic imaging. Results: A total of 63 patients were seen with 25 diagnosed to have CTS (39.7%) and 38 patients had none (60.3%) based on a screening tool. Age ranged from 20-42 years old with the highest range in the 28-30 year old group (34.9%). In patients with CTS, the cross sectional area of the median nerve inside the tunnel was a mean of 0.908 cm ie larger, while non-CTS patients had a mean of 0.797 cm inside the tunnel. The transverse carpal ligament (TCL) measured a mean of 0.0988 cm in the CTS group (ie thinner) and 0.1058 cm in the non-CTS group. Median nerve mobility at equal to or less than one tendon width was 80% in pregnant women with CTS and 92.1% for those without. No fluid was present within the carpal tunnel of all patients. The results were sta- tistically not significant. Conclusion: Ultrasonographic evidence in pregnant women with CTS shows a larger median nerve, a more mobile median nerve and a less thick transverse carpal ligament. There is absence of fluid retention and synovitis ruling out extrinsic compression of the median nerve as cause of CTS in pregnancy.

Matched MeSH terms: Wrist; Wrist Joint
Fulltext Job hazard analyses (JHA) for ergonomics risk factors in Malaysian pineapple plantation

Nur Fazrina Mohamad Salleh, Ezrin Hani Sukadarin

Journal of Occupational Safety and Health, 2018;15(1):17-25.
MyJurnal

The prevalence of Musculoskeletal Symptoms (MSS) rapidly increases and it is recognized as a significant health outcome in agricultural sector. Agricultural ergonomics risk factor is one of hazards constantly arising from all job task activities including awkward postures and heavy lifting. Job hazard analyses (JHA) were conducted to assess the exposure of ergonomics risk factors in Malaysia Pineapple Plantation. The analyses performed involved two steps. They were: 1) guidelines and manual book Malaysia Pineapple Plantation as references; and 2) conducting walkthrough observation based on checklist approaches at the plantation. The identified risk factors were prolonged exposure of standing, squatting, stooping and kneeling, highly repetitive motion on the lower limbs, deviation and twisting of wrist and lastly, heavy lifting. The analyses confirmed that the exposure to ergonomics risk factors in pineapple plantation is high. It would be desirable to reduce the risk factors by educating and training the pineapple workers to perform their task with strong consideration of occupational safety and health.

Matched MeSH terms: Wrist; Wrist Joint
Fulltext Intra- and Inter-observer Variability in Different Methods of Measuring Carpal Collapse

Agrawal S, Chabra T, Pandey S, Bhardwaj P

Malays Orthop J, 2019 Mar;13(1):20-24.
PMID: 31001379 DOI: 10.5704/MOJ.1903.003

Introduction: Carpal collapse of wrist occurs in disorders like rheumatoid arthritis and Kienbock's disease. Three techniques have been described to measure carpal collapse. First, the carpal height ratio (CHR), measured by dividing carpal height by 3rd metacarpal length. Second, the revised carpal height ratio (RCH ratio), measured by dividing carpal height by length of capitate. Third, capitate radius distance (CR index), measured by shortest distance between distal edge of radius and the proximal edge of capitate. The index publications describe good reliability of all these but which method out of the three is best in terms of intra- and inter-observer variability is not known. The purpose of this study was to find out which method had the least inter- and intra-observer variability for determining carpal collapse. Materials and Methods: Fifty normal wrist postero-anterior radiographs were studied by three assessors who measured CHR, RCH ratio and CR index separately. The measurements were repeated after one month by all the three observers. The results were then statistically analysed. Results: The p-value was <0.001 in all the three assessors in CR index meaning that the intra-observer variability was least in CR index. For the inter-observer variability intra class coefficient of 0.9 indicated that the CR index has the least variability. Conclusion: CR index is the most reproducible method to measure carpal collapse. The method which provides accurate measurement of carpal collapse will allow better staging of carpal disorders.

Study site: Grande Hospital, Nepal

Matched MeSH terms: Wrist; Wrist Joint
Fulltext Primary fixation of AO type-C fracture of the distal radius with volar locking plates. A cross-sectional study of patient rated outcomes at Hospital Tengku Ampuan Afzan

Mohd Sallehuddin H, Zamzuri Z, Ariff MS, Mohd Shukrimi A, Mohamed Azril MA, Nazri MY

International Medical Journal Malaysia, 2014;13(2):3-6.
MyJurnal

Introduction: This is a cross-sectional study of 37 patients with AO type C (complete intra-articular) fractures of the distal radius, evaluating the functional, anatomical, and patient rated outcomes one year after primary fixation with a volar locking plate.

Methods: Functional outcomes were assessed based on the grip strength, and the range of motion of forearm and wrist. Anatomical outcomes were assessed based on the radial inclination, radial height, volar tilt, and articular step or gap. Patient rated outcome was measured with a Disability of arm, shoulder and hand (DASH) questionnaire.

Results: One year after surgery, 24 (64%) patients achieved good and excellent anatomical results, and DASH scores were acceptable in 73% of patients. Most of the patients had achieved 80% of their grip strength. The mean DASH score of 12.3 was comparable with other studies. Grip strength, radial inclination and volar tilt had a significant correlation with the DASH score.

Conclusion: Volar locking plates can be used to achieve optimal reduction in all three parameters in the treatment of AO type C fractures of the distal radius. Versatile fracture fragment reduction and angular stability enable rehabilitation hence obtaining good functional outcomes.

Matched MeSH terms: Wrist; Wrist Joint
Fulltext A feasibility study: Use of actigraph to monitor and follow-up sleep/wake patterns in individuals attending community pharmacy with sleeping disorders

Noor ZM, Smith AJ, Smith SS, Nissen LM

J Pharm Bioallied Sci, 2016 Jul-Sep;8(3):173-80.
PMID: 27413344 DOI: 10.4103/0975-7406.171739

INTRODUCTION: Community pharmacists are in a suitable position to give advice and provide appropriate services related to sleep disorders to individuals who are unable to easily access sleep clinics. An intervention with proper objective measure can be used by the pharmacist to assist in consultation.
OBJECTIVES: The study objectives are to evaluate: (1) The effectiveness of a community pharmacy-based intervention in managing sleep disorders and (2) the role of actigraph as an objective measure to monitor and follow-up individuals with sleeping disorders.
METHODS AND INSTRUMENTS: The intervention care group (ICG) completed questionnaires to assess sleep scale scores (Epworth Sleepiness Scale [ESS] and Insomnia Severity Index [ISI]), wore a wrist actigraph, and completed a sleep diary. Sleep parameters (sleep efficiency in percentage [SE%], total sleep time, sleep onset latency, and number of nocturnal awakenings) from actigraphy sleep report were used for consultation and to validate sleep diary. The usual care group (UCG) completed similar questionnaires but received standard care.
RESULTS: Pre- and post-mean scores for sleep scales and sleep parameters were compared between and within groups. A significant difference was observed when comparing pre- and post-mean scores for ISI in the ICG, but not for ESS. For SE%, an increase was found in the number of subjects rated as "good sleepers" at post-assessment in the ICG.
CONCLUSIONS: ISI scores offer insights into the development of a community pharmacy-based intervention for sleeping disorders, particularly in those with symptoms of insomnia. It also demonstrates that actigraph could provide objective sleep/wake data to assist community pharmacists during the consultation.
KEYWORDS:
Actigraph; community pharmacy; intervention; pharmacist; sleeping disorders

Matched MeSH terms: Wrist; Wrist Joint
Fulltext The relation of risk factors and musculoskeletal discomfort among manual material handling workers in Malaysian automotive industries

Mirta Widia, Siti Zawiah Md Dawal, Nukman Yusoff

Malaysian Journal of Public Health Medicine, 2016;16(10):0-0.
MyJurnal

Most studies have examined the association of ergonomic risk factors and musculoskeletal discomfort in developed countries. Meanwhile the data are still lacking in developing countries such as Malaysia. The aim of this study was to determine the relation between risk factors and musculoskeletal discomfort among manual material handling workers in Malaysian automotive industries. A total of211 manual material handling workers from automotive industries completed a set of questionnaire on the individual, physical and environmental factors and the prevalence of musculoskeletal discomfort. The Chi-Square test and logistics regression analysis were used to determine the relationship of the risk factors and musculoskeletal. The findings highlighted that job tenure was significantly correlated with musculoskeletal discomfort among the workers (OR=2.33-5.56). The most significant physical risk factor that was associated with musculoskeletal discomfort was bending the trunk forward slightly, hands above knee level, which was significantly related to lower back discomfort (OR=5.13, 95%CI=1.56-16.8), thigh discomfort (OR=5.1, 95%CI=1.01-25.53) and wrist discomfort (OR=3.65, 95%CI=1.06-12.53). Twisting of the trunk (over 45o) and bending sideways were significantly associated to lower back discomfort (OR=4.04, 95%CI=1.44-14.44), and thigh discomfort (OR=4.3, 95%CI=1.29-8.50). The findings also highlighted that environmental factors was associated with musculoskeletal discomfort (p < 0.05. Musculoskeletal discomfort can be reduced by lowering work-related risk factors among automotive manual material handling workers, particularly by focusing on significant factors, including job tenure, bending or twisting postures and environmental factors.

Matched MeSH terms: Wrist; Wrist Joint
Fulltext Outcome of Tendon Transfers for Radial Nerve Palsy in a Malaysian Tertiary Centre

Richford J, Abdullah S, Norhafizah M, Juliana I, Rashdeen F, Razana A

Malays Orthop J, 2018 Mar;12(1):1-6.
PMID: 29725505 MyJurnal DOI: 10.5704/MOJ.1803.001

Tendon transfers for radial nerve palsy is a common operation with good results. We did a retrospective study on twenty patients with radial nerve palsy who underwent tendon transfer surgery and recovered between January 2008 and December 2012. Outcomes measured were motor power of wrist extension, finger extension, grip strength and DASH scores. There was significant improvement of motor power of wrist and finger extension between the preoperative period and three months post-operatively, between the pre operative period and six months post operatively and between three and six months postoperatively (p = 0.0005). Grip strength improved significantly as well between preoperative, three and six months postoperatively (p = 0.0005). DASH scores reflecting patient satisfaction at six months postoperatively showed only mild or moderate difficulty of function.

Matched MeSH terms: Wrist; Wrist Joint
Fulltext Probable carpal tunnel syndrome and its coping strategies among clinical dental support staff in Hospital Universiti Sains Malaysia

Nurfarah Wahidah Mohd Nor Rasid, Nurul Syafiqah Noh, Munirah Mohd Adnan, Azizah Yusoff

Archives of Orofacial Sciences, 2016;11(2):31-38.
MyJurnal

Prolonged work with highly repetitious flexion and extension of the wrist and forceful grip task were shown to increase the risk of developing carpal tunnel syndrome (CTS) among dental personnel. The present study was carried out to determine the prevalence, risk factors and coping strategies of probable CTS among clinical dental support staff in Hospital Universiti Sains Malaysia (HUSM). A cross-sectional study was conducted and a set of questionnaire consisting of socio-demographic status, work-related and psychosocial risk factors and coping strategies was distributed. Ninety-five clinical dental support staff completed and returned the questionnaire with a response rate of 80.5%. The prevalence of probable CTS was 38.9%, with the highest prevalence was found among dental surgery assistants (40.5%) followed by dental technologists (29.7%). There was no significant association between work-related or psychosocial risk factors with probable CTS (p>0.05). Most of the respondents with symptoms of CTS chose religion as the coping mechanism; mean 7.11 (SD 1.13). Awareness training should be emphasized among clinical dental support staff on the prevention of CTS.

Study site: Hospital Universiti Sains Malaysia (HUSM)

Matched MeSH terms: Wrist; Wrist Joint
Gamification in rehabilitation of metacarpal fracture using cost-effective end-user device: A randomized controlled trial

Then JW, Shivdas S, Tunku Ahmad Yahaya TS, Ab Razak NI, Choo PT

J Hand Ther, 2020 05 16;33(2):235-242.
PMID: 32430167 DOI: 10.1016/j.jht.2020.03.029

STUDY DESIGN: This is a two-group randomized controlled trial.
INTRODUCTION: Finger stiffness after treatment for metacarpal fractures often occurs due to poor compliance to the conventional rehabilitation programs. Gamification has shown success in improving adherence to and effectiveness of various therapies.
PURPOSE OF THE STUDY: The purpose of this study was to evaluate whether gamification, using cost-effective devices was comparable with conventional physiotherapy in improving hand functions and adherence to rehabilitation in metacarpal fractures.
METHODS: A 2-group randomized controlled trial involving 19 patients was conducted. Participants were randomized to a control (conventional physiotherapy, n = 10) or interventional group (gamification, n = 9). The grips strength and composite finger range of motion were measured at the baseline and each follow-up together with Patient-Rated Wrist and Hand Evaluation scores and compliance.
RESULTS: There were no significant differences on improvements of grip strength (means difference 24.38 vs 20.44, P = .289) and composite finger range of motion (means difference 50.50 vs 51.11, P = .886). However, the gamification group showed better results in Patient-Rated Wrist and Hand Evaluation (mean 0.44 vs 8.45, P = .038) and compliance (P

Matched MeSH terms: Wrist; Wrist Joint
Fulltext Wide Awake Local Anesthesia No Tourniquet Forearm Triple Tendon Transfer in Radial Nerve Palsy

Abdullah S, Ahmad AA, Lalonde D

Plast Reconstr Surg Glob Open, 2020 Aug;8(8):e3023.
PMID: 32983779 DOI: 10.1097/GOX.0000000000003023

Tendon transfer for radial nerve palsy is a common procedure done under general anesthesia. We describe a surgical technique of triple tendon transfer with wide awake local anesthesia no tourniquet (WALANT). We transfer flexor carpi radialis to extensor digitorum communis, palmaris longus to extensor pollicis longus, and pronator teres to extensor carpi radialis brevis. This is commonly known as the Brand transfer. Our anesthetic or WALANT solution consists of up to 200 mL of 1:400,000 epinephrine, 0.25% lidocaine buffered with sodium bicarbonate. This technique overcomes the problem of judging the appropriate amount of transfer tension by observing awake patients actively extend their fingers, thumb, and wrist during the surgery and making adjustments before we close the wound. In our experience, there is no need of brain retraining because a patient is able to immediately use the flexor muscles to perform extension movements. WALANT is a safe and viable option for radial nerve tendon transfers.

Matched MeSH terms: Wrist; Wrist Joint
Fulltext Multiple variations of the tendons of the anatomical snuffbox

Thwin SS, Fazlin F, Than M

Singapore Med J, 2014 Jan;55(1):37-40.
PMID: 24452976

Multiple tendons of the abductor pollicis longus (APL) in the anatomical snuffbox of the wrist can lead to the development of de Quervain's syndrome, which is caused by stenosing tenosynovitis. A cadaveric study was performed to establish the variations present in the tendons of the anatomical snuffbox in a Malaysian population, in the hope that this knowledge would aid clinical investigation and surgical treatment of de Quervain's tenosynovitis.

Matched MeSH terms: Wrist/anatomy & histology*
Reverse Wafer Procedure for Ulnar Impaction Syndrome

Ozcelik IB, Jusoh MH, Cavit A

Tech Hand Up Extrem Surg, 2024 Mar 01;28(1):16-18.
PMID: 37702374 DOI: 10.1097/BTH.0000000000000453

Ulnar impaction syndrome occurs when excessive load across the ulnocarpal joints results in pathologic changes, especially over the articular surface of the ulnar head and proximal ulnar corner of the lunate. The 2 main surgical options in ulnar impaction syndrome are ulnar shortening osteotomy and wafer procedure, whether open or arthroscopically, to decompress the ulnocarpal joint load. However, all of these techniques have their shortcomings and drawbacks. The current study demonstrates a novel technique to decompress the ulnocarpal joint load: the "reverse wafer procedure" for ulnar impaction syndrome. In this surgical technique, we resected the proximal ulnar side of the lunate instead of partial resection of the thin wafer of the distal ulnar head dome in the standard wafer procedure. This technique avoids iatrogenic central tear of triangular fibrocartilage and distal radioulnar joint portal arthroscopy, which is technically demanding while preserving the distal radioulnar joint.

Matched MeSH terms: Wrist Joint/surgery
Fulltext Development and performance of a new prosthesis system using ultrasonic sensor for wrist movements: a preliminary study

Abd Razak NA, Abu Osman NA, Gholizadeh H, Ali S

Biomed Eng Online, 2014 Apr 23;13:49.
PMID: 24755242 DOI: 10.1186/1475-925X-13-49

BACKGROUND: The design and performance of a new development prosthesis system known as biomechatronics wrist prosthesis is presented in this paper. The prosthesis system was implemented by replacing the Bowden tension cable of body powered prosthesis system using two ultrasonic sensors, two servo motors and microcontroller inside the prosthesis hand for transradial user.
METHODS: The system components and hand prototypes involve the anthropometry, CAD design and prototyping, biomechatronics engineering together with the prosthetics. The modeler construction of the system develop allows the ultrasonic sensors that are placed on the shoulder to generate the wrist movement of the prosthesis. The kinematics of wrist movement, which are the pronation/supination and flexion/extension were tested using the motion analysis and general motion of human hand were compared. The study also evaluated the require degree of detection for the input of the ultrasonic sensor to generate the wrist movements.
RESULTS: The values collected by the vicon motion analysis for biomechatronics prosthesis system were reliable to do the common tasks in daily life. The degree of the head needed to bend to give the full input wave was about 45°-55° of rotation or about 14 cm-16 cm. The biomechatronics wrist prosthesis gave higher degree of rotation to do the daily tasks but did not achieve the maximum degree of rotation.
CONCLUSION: The new development of using sensor and actuator in generating the wrist movements will be interesting for used list in medicine, robotics technology, rehabilitations, prosthetics and orthotics.

Matched MeSH terms: Wrist/physiology*
Fulltext Traumatic floating clavicle: a case report

Choo C, Wong H, Nordin A

Malays Orthop J, 2012 Nov;6(3):57-9.
PMID: 25279061 MyJurnal DOI: 10.5704/MOJ.1207.008

Shoulder girdle injuries after high energy traumatic impacts to the shoulder have been well documented. Based on the series of 1603 injuries of the shoulder girdle reported by Cave and colleagues, 85% of the dislocations were glenohumeral, 12% acromioclavicular and 3% sternoclavicular (1). Less frequently described are injuries involving both the sternoclavicular and acromioclavicular joints simultaneously in one extremity. The present report discusses a case of traumatic floating clavicle associated with ipsilateral forearm and wrist injury which was treated surgically.

Matched MeSH terms: Wrist Injuries
Fulltext Validity test for Simple Ergonomics Risk Assessment (SERA) method

Ezrin Hani Sukadarin, Baba Md Deros, Jaharah A. Ghani, Ahmad Rasdan Ismail, Nur Syazwani Mohd Nawi, Norhidayah Abdull

Malaysian Journal of Public Health Medicine, 2016;16(10):0-0.
MyJurnal

Validity test is important during the development of ergonomics measurement. Failure to conduct validity tests will result in the measurement method being developed to be incapable of providing reliable ergonomics measurements. The objective of this study is to conduct validity test on the simple method ergonomics measurement which was developed. The method named Simple Ergonomics Risks Assessment (SERA). Content validity test and criterion validity test were conducted. The content validity test consists of 6 ergonomics experts who actively provide inputs and positive feedbacks to improve the measurement method being developed. Meanwhile, the criterion validity test involves data collection of complaints on body parts among oil palm workers which were derived from Nordic Musculoskeletal Questionnaire (NMQ) and ergonomics risk assessment scores obtained from SERA. Both findings were tested with the Chi-square test to explore possible relations between the two findings. Results from the test conducted showed that there are significant relations in the scores of neck posture; hip, right and left shoulder, right and left wrists and the right hand associated with fresh fruit bunch (FFB) harvesting activities. In the loose fruits collection, the Chi-square test showed significant relations in the scores of neck posture, hip, right and left shoulders, right wrist, right arm and the left hand. However, there are body parts such as the legs which showed no significant relation. More tests should be conducted to further explore the validity of the method being developed. Findings from both validity tests show that SERA were verified by the experts and tested with validated method so that it is valid to be applied in the future.

Matched MeSH terms: Wrist
Photobiomodulation Therapy in Carpal Tunnel Release: A Randomized Controlled Trial

Chuah JP, Khoo SS, Chung TY, Jayaletchumi G

Photobiomodul Photomed Laser Surg, 2023 Aug;41(8):402-407.
PMID: 37506348 DOI: 10.1089/photob.2023.0018

Background: Carpal tunnel release (CTR) is widely accepted as an effective treatment for carpal tunnel syndrome. However, the recovery is often delayed and incomplete. Photobiomodulation therapy (PBMT) produces a nonthermal effect on living tissues; it promotes healing, remodels and reduces inflammation of an injured nerve. The purpose of this study was to compare the outcome of CTR between patients who underwent postoperative PBMT and without PBMT. Materials and methods: We recruited 105 patients who had open CTR from January 2019 to January 2021. Fifty-six patients fulfilled the study criteria and were randomized into two groups: with PBMT (n = 28) and without PBMT (n = 28). Demographic and clinical data were obtained preoperatively. The PBMT group had ten 3-min sessions over 3 weeks using 808 nm, 50 mW PBMT to deliver 9 J per session to the CTR incision scar. Clinical outcomes were assessed at 1, 3, and 6 months postoperatively. Data analysis was performed with SPSS software. Results: There were significant improvements in the Functional Status Scale in the Boston Carpal Tunnel Questionnaire (p = 0.018) and pain (visual analogue scales) in the morning (p = 0.019) at 1 month postoperatively in the PBMT group compared with the non-PBMT group. Improvement of tip pinch strength at 3 months (p = 0.022) and 6 months (p = 0.024), lateral pinch strength at 1 month (p = 0.042) and 3 months (p = 0.05), and tripod pinch strength at 3 months (p = 0.005) was significantly better in the PBMT group. Thumb 2-point discrimination (2PD) at 3 months (p = 0.018) and 6 months (p = 0.016) and index finger 2PD at 3 months (p = 0.039) were also significantly improved in the PBMT group. There were no side effects of PBMT reported. Conclusions: Patients who underwent PBMT post-CTR had better outcomes. PBMT may be a valuable adjunct to post-CTR care.

Matched MeSH terms: Wrist
The applicability of Greulich and Pyle atlas to assess skeletal age for four ethnic groups

Mansourvar M, Ismail MA, Raj RG, Kareem SA, Aik S, Gunalan R, et al.

J Forensic Leg Med, 2014 Feb;22:26-9.
PMID: 24485416 DOI: 10.1016/j.jflm.2013.11.011

Recently, determination of skeletal age, defined as the assessment of bone age, has rapidly become an important task between forensic experts and radiologists. The Greulich-Pyle (GP) atlas is one of the most frequently used methods for the assessment of skeletal age around the world. After presentation of the GP approach for the estimation of the bone age, much research has been conducted to examine the usability of this method in various geographic or ethnic categories. This study investigates on a small-scale and compares the reliability of the GP atlas for assessment of the bone age for four ethnic groups - Asian, African/American, Caucasian and Hispanic - for a different range of ages.

Matched MeSH terms: Wrist Joint/anatomy & histology; Wrist Joint/radiography*
Biomechanical analysis of the wrist arthroplasty in rheumatoid arthritis: a finite element analysis

Bajuri MN, Abdul Kadir MR, Murali MR, Kamarul T

Med Biol Eng Comput, 2013 Feb;51(1-2):175-86.
PMID: 23124814 DOI: 10.1007/s11517-012-0982-9

The total replacement of wrists affected by rheumatoid arthritis (RA) has had mixed outcomes in terms of failure rates. This study was therefore conducted to analyse the biomechanics of wrist arthroplasty using recently reported implants that have shown encouraging results with the aim of providing some insights for the future development of wrist implants. A model of a healthy wrist was developed using computed tomography images from a healthy volunteer. An RA model was simulated based on all ten general characteristics of the disease. The ReMotion ™ total wrist system was then modelled to simulate total wrist arthroplasty (TWA). Finite element analysis was performed with loads simulating the static hand grip action. The results show that the RA model produced distorted patterns of stress distribution with tenfold higher contact pressure than the healthy model. For the TWA model, contact pressure was found to be approximately fivefold lower than the RA model. Compared to the healthy model, significant improvements were observed for the TWA model with minor variations in the stress distribution. In conclusion, the modelled TWA reduced contact pressure between bones but did not restore the stress distribution to the normal healthy condition.

Matched MeSH terms: Wrist Joint/physiopathology*; Wrist Joint/surgery*

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