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Experts Unravel the 'Mysteries of Wrist Motion'

Medscape interviews HSS hand and upper extremity surgeon Scott W. Wolfe, MD about recent developments in wrist kinematics and arthroplasty.

Dr. Wolfe explained “the markerless bone registration technique” he used when studying wrist kinematics and the discovery of the "dart-throwers motion" (DTM) plane being essential to nearly all precision activities that humans do, combining force and accuracy. This led to further study of where that motion occurred (predominantly in a single joint in the wrist called the midcarpal joint). “Many people across the globe agree with this theory of dart-throwing and midcarpal motion, and are coming up with techniques to leverage that understanding,” said Dr. Wolfe. “So with that, we were able to devise different ways of reconstructing the wrist to preserve that midcarpal joint and allow people to have a more complete coupled motion path in the activities that they do. And the last stage is to develop a wrist prosthesis, a wrist arthroplasty that uses that plane of motion,” he added.

Dr. Wolfe discussed the wrist prosthesis approved in CE and Australia, and the published four-year outcomes results on midcarpal hemiarthroplasty for wrist arthritis, which demonstrated significantly increases in the range of motion in every plane and in patient-related outcome scores (the Mayo score and the DASH score).

SLAC (scaphoid lunate advanced collapse) wrist arthritis will never go away and current SLAC wrist solutions seem inadequate for highly active individuals. Dr. Wolfe noted, “The next phase will be to identify an individual's needs and expectations prior to surgery, and to try to match them with a customized solution that will best meet those needs in a durable fashion.

Read the full article at Medscape.com