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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
40
We compare two different mobilisations in the rehabilitation of patients following scapholunate ligament reconstruction
Balgrist University Hospital
Zurich, Canton of Zurich, Switzerland
RECRUITINGPain in resting position
Assessment of resting pain using the VAS Score (Visual Analog Scale), where 0 indicates no pain and 10 indicates the worst pain.
Time frame: Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery
Pain during activity
Assessment of pain during activity using the VAS (Visual Analog Scale), where 0 indicates no pain and 10 indicates the worst pain
Time frame: Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery
Mobility of the wrist: Flexion
Assessment of wrist flexion by measuring the range of motion in degrees.
Time frame: Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery
Mobility of the wrist: Extension
Assessment of wrist extension by measuring the range of motion in degrees.
Time frame: Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery
Mobility of the wrist: Ulnar deviation
Assessment of wrist ulnar deviation by measuring the range of motion in degrees.
Time frame: Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery
Mobility of the wrist: Pronation
Assessment of wrist pronation by measuring the range of motion in degrees.
Time frame: Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery
Mobility of the wrist: Supination
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Assessment of wrist supination by measuring the range of motion in degrees.
Time frame: Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery
Strength Assessment: Grip Strength
Using the Jamar Hydraulic Hand Dynamometer which displays isometric grip force from 0-90 kg, grip strength will be assessed.
Time frame: Before surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery
Recording ability to work
Degree of employment in per cent (from 0 to a maximum of 100 per cent) is recorded
Time frame: Before surgery, 7 weeks after surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery
Recording of physical limitations
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).
Time frame: Before surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery
Recording wrist pain and restrictions
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.
Time frame: Before surgery, 11 weeks after surgery, 6 months after surgery, 12 months after surgery