Biomechanical assessment of a prophylactic wrist orthosis during mechanical loading in a cadaveric model.

摘要

The purpose of this study was to assess the biomechanical effects of a prophylactic wrist orthosis on the wrist and ulnocarpal joints during mechanical loading in a cadaveric model. Twelve fixed cadaveric wrist specimens were subjected to a 71.4 lb compressive load on the dorsiflexed wrist.; The research design consisted of a randomized block design. The independent variables were orthotic condition (within subjects factor) and ulnar variance (categorical factor) and sex (categorical factor). Orthotic condition consisted of the Ezy® ProBrace with palmar pad, the Ezy® ProBrace without palmar pad, and a non-orthotic control. Ulnar variance consisted of positive ulnar variance, negative ulnar variance, and neutral ulnar variance. The dependent variables were wrist joint dorsiflexion angle (measured with a hand-held goniometer) and ulnocarpal joint intracompartment peak pressure (measured with a Stryker® Intracompartmental Pressure Monitor). Analysis consisted of a repeated measures multivariate analysis of variance with univariate analysis of variance and extended Scheffé post hoc analyses.; Wrist joint dorsiflexion angle was significantly lower for the Ezy ® ProBrace with palmar pad (7.7%) and without the palmar pad (5.8%) than for the non-orthotic control. Ulnocarpal joint intracompartmental peak pressure was significantly lower for the Ezy® ProBrace with palmar pad (23%) than for the Ezy® ProBrace without palmar pad. Additionally, ulnocarpal joint intracompartmental peak pressure was significantly lower for the Ezy® ProBrace with palmar pad (31.6%) than for the non-orthotic control. Ulnocarpal joint intracompartmental peak pressure was 120 higher for female specimens than for male specimens.; Within the limitations of the cadaveric model and the test protocol used in this study, wrist joint dorsiflexion angle was reduced by the Ezy ® ProBrace with and without the palmar pad. However, ulnocarpal joint intracompartmental peak pressure was reduced by the Ezy® ProBrace with palmar pad only. From a clinical perspective, prevention of pathological gymnastic wrist changes requires intervention in pressure attenuation. The Ezy® ProBrace with palmar pad was beneficial in pressure attenuation. Use of this orthosis during pommel horse training in gymnasts may be prophylactically beneficial in decreasing the cumulative consequences of the repetitive stress of pommel horse exercise training. In addition to enhancing gymnastics safety for participants, a viable method for directly measuring ulnocarpal joint intracompartmental peak pressure in vivo has emerged.