2003The American Journal of Sports MedicineRequires access

Effect of a Prophylactic Brace on Wrist and Ulnocarpal Joint Biomechanics in a Cadaveric Model

Marsha Grant-Ford, Michael R. Sitler, Scott H. Kozin, Mary Frances Barbe, Ann E. Barr

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Abstract

BACKGROUND: Wrist pain from repetitive dorsiflexion and compression during pommel horse exercises is common among male gymnasts. PURPOSE: To determine the biomechanical effects of a prophylactic wrist brace on the wrist and ulnocarpal joints during mechanical loading in a cadaveric model. HYPOTHESIS: The lateral wedge of the palmar pad of the brace will compensate for positive ulnar variance, distributing contact forces more evenly across the radioulnar carpal joint. STUDY DESIGN: Controlled laboratory study. METHODS: Six male and six female fixed cadaveric forearm-wrist specimens were subjected to a 32.13-kg compressive load applied through the long axis of the pronated forearm with a dorsiflexed wrist in contact with a support surface. Wrist joint dorsiflexion angle and ulnocarpal joint intraarticular peak pressure were assessed under three brace conditions: Ezy ProBrace with and without palmar pad and a nonbraced control. RESULTS: Wrist joint dorsiflexion angle was significantly reduced by the Ezy ProBrace with and without the palmar pad. However, ulnocarpal joint intraarticular peak pressure was reduced only by the brace with pad. CONCLUSION: Prevention of pathologic wrist changes requires intervention in pressure attenuation, which was achieved with the Ezy ProBrace with palmar pad. CLINICAL RELEVANCE: This brace may decrease the cumulative effects of repetitive stress of pommel horse exercise training.

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BACKGROUND: Wrist pain from repetitive dorsiflexion and compression during pommel horse exercises is common among male gymnasts. PURPOSE: To determine the biomechanical effects of a prophylactic wrist brace on the wrist and ulnocarpal joints during mechanical loading in a cadaveric model. HYPOTHESIS: The lateral wedge of the palmar pad of the brace will compensate for positive ulnar variance, distributing contact forces more evenly across the radioulnar carpal joint. STUDY DESIGN: Controlled laboratory study. METHODS: Six male and six female fixed cadaveric forearm-wrist specimens were subjected to a 32.13-kg compressive load applied through the long axis of the pronated forearm with a dorsiflexed wrist in contact with a support surface. Wrist joint dorsiflexion angle and ulnocarpal joint intraarticular peak pressure were assessed under three brace conditions: Ezy ProBrace with and without palmar pad and a nonbraced control. RESULTS: Wrist joint dorsiflexion angle was significantly reduced by the Ezy ProBrace with and without the palmar pad. However, ulnocarpal joint intraarticular peak pressure was reduced only by the brace with pad. CONCLUSION: Prevention of pathologic wrist changes requires intervention in pressure attenuation, which was achieved with the Ezy ProBrace with palmar pad. CLINICAL RELEVANCE: This brace may decrease the cumulative effects of repetitive stress of pommel horse exercise training.

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Available abstract

BACKGROUND: Wrist pain from repetitive dorsiflexion and compression during pommel horse exercises is common among male gymnasts. PURPOSE: To determine the biomechanical effects of a prophylactic wrist brace on the wrist and ulnocarpal joints during mechanical loading in a cadaveric model. HYPOTHESIS: The lateral wedge of the palmar pad of the brace will compensate for positive ulnar variance, distributing contact forces more evenly across the radioulnar carpal joint. STUDY DESIGN: Controlled laboratory study. METHODS: Six male and six female fixed cadaveric forearm-wrist specimens were subjected to a 32.13-kg compressive load applied through the long axis of the pronated forearm with a dorsiflexed wrist in contact with a support surface. Wrist joint dorsiflexion angle and ulnocarpal joint intraarticular peak pressure were assessed under three brace conditions: Ezy ProBrace with and without palmar pad and a nonbraced control. RESULTS: Wrist joint dorsiflexion angle was significantly reduced by the Ezy ProBrace with and without the palmar pad. However, ulnocarpal joint intraarticular peak pressure was reduced only by the brace with pad. CONCLUSION: Prevention of pathologic wrist changes requires intervention in pressure attenuation, which was achieved with the Ezy ProBrace with palmar pad. CLINICAL RELEVANCE: This brace may decrease the cumulative effects of repetitive stress of pommel horse exercise training.

Key concepts: Wrist, Brace, Cadaveric spasm, Medicine, Biomechanics, Forearm, Orthodontics, Anatomy

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