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Dart-Splint: An innovative orthosis that can be integrated into a scapho-lunate and palmar midcarpal instability re-education protocol

Published:January 27, 2015DOI:https://doi.org/10.1016/j.jht.2015.01.007
      The Authors describe a novel hinged orthosis that permits selective midcarpal mobilization along the plane of the dart throwing motion. This orthotic device can be used to assist rehabilitation protocols aimed to limit radiocarpal joint mobility and scapho-lunate ligament overload and to accelerate wrist functional recovery after ligamentous injuries around the proximal carpal row. – Victoria W. Priganc, PhD, OTR, CHT, CLT, Practice Forum Editor
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      References

        • Moritomo H.
        • Apergis E.
        • Herzberg G.
        • et al.
        2007 IFSSH Committee Report of Wrist Biomechanics Committee: biomechanics of the so-called dart-throwing motion of the wrist.
        J Hand Surg Am. 2007; 32: 1447-1453
        • Moritomo H.
        • Murase T.
        • Goto A.
        • Sugamoto K.
        • Yoshikawa H.
        In vivo 3-dimensional kinematics of the midcarpal joint of the wrist.
        J Bone Joint Surg Am. 2006; 88: 611-621
        • Vesalius A.
        De Humani Corporis Fabrica.
        (Basle)1543
        • Henke W.
        Die Bewegungen der Handwurzel.
        Z Rat Med. 1859; 7: 27
        • Linscheid R.L.
        Carpal comprehension: a short look at a history of understanding the wrist joint.
        in: Cooney W.P. Linscheid R.L. Dobyns J.H. The Wrist. Diagnosis and Operative Treatment. Mosby, St Louis1998: 2-13
        • Moritomo H.
        • Viegas S.F.
        • Nakamura K.
        • et al.
        The scaphotrapezio-trapezioidal joint Part 1: an anatomic and radiographic study.
        J Hand Surg Am. 2000; 25: 899-910
        • Moritomo H.
        • Murase T.
        • Goto A.
        • et al.
        In vivo three-dimensional kinematics of the midcarpal joint of the wrist.
        J Bone Joint Surg Am. 2006; 88: 611-621
        • Calfee R.P.
        • Leventhal E.L.
        • Wilkerson J.
        • et al.
        Simulated radioscapholunate fusion alters carpal kinematics while preserving dart-throwers motion.
        J Hand Surg. 2008; 33A: 503-510
        • Upall M.A.
        • Crisco J.J.
        • Moore D.C.
        • et al.
        In vivo elongation of the palmar and dorsal scapholunate interosseous ligament.
        J Hand Surg. 2006; 31: 1326-1332
        • Werner F.W.
        • Short W.H.
        • Green J.K.
        Changes in patterns of scaphoid and lunate motion during functional arcs of wrist motion induced by ligament division.
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        • Short W.H.
        • et al.
        Scaphoid and lunate motion during a wrist dart throw motion.
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        • Crisco J.J.
        • Coburn J.C.
        • Moore D.C.
        • et al.
        In vivo kinematics and the dart thrower's motion.
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        • Mclean J.M.
        • Turner P.C.
        • Bain G.I.
        • et al.
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        J Hand Surg Eur Vol. December 2009; 34: 778-782
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      JHT Read for Credit

      Quiz: #376

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
      • #1.
        The DTM is composed of
        • a.
          radial wrist extension and flexion
        • b.
          ulnar wrist flexion and extension
        • c.
          ulnar wrist extension and radial wrist flexion
        • d.
          radial wrist extension and ulnar wrist flexion
      • #2.
        The DTM may be referred to as movement in
        • a.
          the coronal plane
        • b.
          the sagittal plane
        • c.
          an oblique plane
        • d.
          the X-Y axis
      • #3.
        The DTM
        • a.
          directs more motion at the midcarpal joint than the radiocarpal joint
        • b.
          directs more motion at the scapholunate joint than the midcarpal joint
        • c.
          spares the scapholunate joint
        • d.
          spares the midcarpal joint
      • #4.
        Rivets are placed over the
        • a.
          lunate and the capitate
        • b.
          hamate and the tubercle of the scaphoid
        • c.
          hook of the hamate and the proximal pole of the scaphoid
        • d.
          dorsal triquetrum and volar trapezium
      • #5.
        The primary joint that is protected is the S-L joint
        • a.
          false
        • b.
          true
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.