The Pronator Quadratus (PQ) is commonly damaged in the surgical approach to the distal radius during volar plating. This study explored the functional strength of the PQ muscle, 12 months after volar plating of a distal radial fracture.

Testing of treated and contralateral forearms was carried out using a custom-made Torque Measuring Device (TMD) and surface Electromyography (sEMG). To assess both the direct and indirect function of PQ in participants treated with volar plating and compared to the contralateral non-injured forearms. The angle of elbow flexion was varied from 45o, 90o and 135o when measuring forearm pronation. Mean peak torque of the major pronating muscles, PQ and Pronator Teres (PT) was directly measured with the TMD and the indirect activation of the PQ and PT was measured with sEMG.

In total 27 participants were studied. A statistically significant reduction in mean peak pronation torque was observed in the volar plated forearms (P<0.05 SE 0.015, CI 95%). This is unlikely to be of clinical significance as the mean reduction was small (13.43Nm treated v 13.48Nm none treated). Pairwise comparison found no statistically significant reduction in peak torque between 45o, 90o and 135o of elbow flexion. There was an increase in PQ muscle activation at 135o compared to 45o elbow flexion. The converse was identified in PT.

The small but statistically significant difference in mean peak torque in treated and uninjured forearms is unlikely to be of clinical significance and results suggest adequate functional recovery of the PQ after volar plating.

Introduction

There is limited evidence assessing the effect of the Ankle Foot Orthosis (AFO) on gait improvements in diplegic cerebral palsy. In particular, the effect of the AFO on vertical forces during gait has not been reported. Appropriate vertical ground reaction forces are crucial in enabling children with CP to walk efficiently. This study investigated the effect of AFO application on the vertical forces in gait, particularly the second vertical peak in force (FZ2) in late stance. The force data was compared with the barefoot walk.

Dynamic assessment of the wrist motion and the specific angles are difficult using the conventional methods. We wanted to adapt and assess the repeatability of the Fas-trak system for continuous monitoring of three dimensional (3 D) wrist movements.

Twenty seven volunteers, aged 18 to 30 years were asked to perform predetermined tasks. The exclusion criteria were previous history of wrist trauma or joint disease. The transmitter was mounted on the dorsum of the forearm while the sensor was placed over the third metacarpal head. The protocol of three tasks was developed. Task 1 measured maximal flexion, extension, radial and ulnar deviation of the wrist. Task 2 involved picking up an object and moving it across a barrier. Task 3 involved the writing simulation. The comparison between the left and the right wrists indicated suitability of the system to be used on either of the limbs. Repeated measurements on the right wrist provided an assessment of repeatability of the Fastrak system.

The Fastrak system was successful in acquiring data in 3 D. The transmitter and the sensor were easy to attach and were of no discomfort to the subjects. As expected the maximum movement was noted in the flexion-extension plane. The total arc of movement in the flexion-extension plane was 127.1 degrees and 69.7 degrees in the radio-ulnar plane. There was no statistically signifi-cant difference between the movements in the left and the right wrists, even when the effect of dominance was considered. The lift and move task showed that most subjects utilised three-fourths of the total possible radio-ulnar movement, but only one-thirds of the total flexion and extension. The writing simulation revealed a substantial variability between subjects. The Fastrak system revealed variation up to 3 degrees in the means of range of movements, while measuring wrist movements.

The current study showed that the Fastrak system is a user-friendly and repeatable device, which could be used in everyday clinical use. It has the potential to be used for evaluation of the diseased wrist and the results of therapeutic interventions, operative or otherwise.