Scapholunate Ligament Rupture
Conditions
Keywords
Mobilisation, Scapholunate ligament recontruction
Brief summary
Patients undergoing scapholunate ligament reconstruction at Balgrist University Hospital are divided into two groups and receive two different types of mobilisation postoperatively. The investigators will compare the outcome (pain, strength, mobility) between the two groups 1 year after the operation.
Detailed description
The so-called 'dart-throwing motion' (DTM) plane of movement, from radial extension to ulnar flexion, has gained attention as it has been shown to be an important axis of wrist movement during activities of daily living. Further studies have shown that during movement of the intact wrist in the dart throwing plane, most of the movement occurs in the mediocarpal joint, while the proximal row remains relatively immobile. In scapholunate (SL) ligament reconstruction using the flexor carpi radialis tendon, the SL interval is immobilised using 2 Kirschner wires for 8-10 weeks to relieve the strain on the ligament and allow it to heal. From the 2nd postoperative week, mobilisation is started using DTM mobilisation or mobilisation in the anatomical plane. The aim of the study is to investigate in a randomised trial whether mobilisation in the anatomical plane produces the same postoperative results. In this project, the investigators will compare two types of mobilisation in the rehabilitation of SL ligament reconstruction. The participants will be randomised to two treatment groups. This procedure therefore corresponds to a risk category A in 'other' clinical trials according to Chapter 4 ClinO.
Interventions
OTHEREarly dart throwing motion-mobilization
We compare two different mobilisations in the rehabilitation of patients following scapholunate ligament reconstruction
Sponsors
Lisa Reissner
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* SL Ligament reconstruction at Balgrist University Hospital * at least 18 years * Written informed consent
Exclusion criteria
* Age under 18 years * Refusal of participation * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Strength Assessment: Grip Strength | Before surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery | Using the Jamar Hydraulic Hand Dynamometer which displays isometric grip force from 0-90 kg, grip strength will be assessed. |
| Mobility of the wrist: Ulnar deviation | Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery | Assessment of wrist ulnar deviation by measuring the range of motion in degrees. |
| Mobility of the wrist: Pronation | Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery | Assessment of wrist pronation by measuring the range of motion in degrees. |
| Mobility of the wrist: Supination | Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery | Assessment of wrist supination by measuring the range of motion in degrees. |
| Pain in resting position | Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery | Assessment of resting pain using the VAS Score (Visual Analog Scale), where 0 indicates no pain and 10 indicates the worst pain. |
| Pain during activity | Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery | Assessment of pain during activity using the VAS (Visual Analog Scale), where 0 indicates no pain and 10 indicates the worst pain |
| Mobility of the wrist: Flexion | Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery | Assessment of wrist flexion by measuring the range of motion in degrees. |
| Mobility of the wrist: Extension | Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery | Assessment of wrist extension by measuring the range of motion in degrees. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Recording of physical limitations | Before surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery | Using the DASH (Disabilities of the Arm, Shoulder, and Hand) questionnaire, physical limitation will be recorded. This 30-item questionnaire allows patients to rate difficulty and interference with daily life on a 5-point Likert scale. The scores are then used to calculate a scale score ranging from 0 (no disability) to 100 (most severe disability). |
| Recording wrist pain and restrictions | Before surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery | Using the PRWE (Patient-Rated Wrist Evaluation) questionnaire, specific wrist pain and restrictions will be recorded. This 15-item questionnaire measures wrist pain and disability in daily activities. Patients rate their wrist pain and disability from 0 (no pain) to 10 (worst pain). * Pain subscale:Contains 5 items, each rated from 0 to 10, with a maximum score of 50 and a minimum of 0. * Function subscale: Contains 10 items divided into two sections: specific activities (6 items) and usual activities (4 items). The maximum score is 50 and the minimum is 0. |
| Recording ability to work | Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery | Degree of employment in per cent (from 0 to a maximum of 100 per cent) is recorded |
Countries
Switzerland
Contacts
Primary ContactLisa Reissner, PD
Backup ContactAndreas Schweizer, Prof
Outcome results
None listed