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British Orthopaedic Research Society (BORS)


Several authors have used 3D motion analysis to measure upper limb kinematics, but none have focused solely on wrist movements, in six degrees of freedom, during activities of daily living (ADL). This study aimed to determine the role of the different planar wrist movements during three standardised tasks, which may be affected by surgical procedures.

Nine volunteers (age range 22-45) were recruited and each participant performed three simulated ADLs: using a door lever, a door knob and opening/closing a jam jar. The ADLs were simulated using a work-sim kit on an isokinetic dynamometer. Motion analysis was performed by a 10-camera Oqus system (Qualisys Medical AB, Gothenburg, Sweden). All raw kinematic data were exported to Visual3D (C-Motion Inc.), where the biomechanical model was defined and joint kinematics calculated.

Table 1 shows a similar range of radial-ulnar deviation and flexion-extension as previous studies. However a substantial amount of wrist rotation also occurred in all tasks. This was significantly greater when using the door lever compared with the door knob and jam jar tasks.

Previous studies have stated that a negligible degree of rotation occurs at the wrist. This study found a maximum mean of 31.7 degrees of wrist rotation. This indicates that considerable rotational movement occurs at the wrist during certain functional tasks. Surgical approaches and clinical pathology may disrupt structures responsible for rotational stability. Further investigation of this rotational component of carpal movement during additional ADLs is proposed in both normal and clinical subjects, to explore the potential relationship between carpal surgery and rotational laxity.