Joseph A. Buckwalter V MD, PhD , Noah M. Scigliano BS , Ignacio Garcia Fleury MD , Nicole A.D. Watson PhD , Kevin N. Dibbern PhD , Natalie A. Glass PhD , Jessica E. Goetz PhD
{"title":"Altered Ulnar Variance With Full-Body Weight-Bearing During Handstands With Upper Extremity Weight-Bearing CT","authors":"Joseph A. Buckwalter V MD, PhD , Noah M. Scigliano BS , Ignacio Garcia Fleury MD , Nicole A.D. Watson PhD , Kevin N. Dibbern PhD , Natalie A. Glass PhD , Jessica E. Goetz PhD","doi":"10.1016/j.jhsa.2023.09.010","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Ulnar variance (UV) is a radiographic measurement relating the articular surface<span><span> heights of the distal radius and ulna. Abnormal UV increases the risk for wrist pathology; however, it only provides a static measurement of an inherently dynamic bony relationship that changes with wrist position and loading. The purpose of this study was to investigate how full-body weight-bearing affects UV using weight-bearing </span>computed tomography (WBCT).</span></div></div><div><h3>Methods</h3><div>Ten gymnasts completed two 45-second scans inside a WBCT machine while performing a handstand on a flat platform (H) and parallettes (P). A non–weight-bearing CT scan was collected to match clinical practice (N). Differences in UV between weight-bearing conditions were evaluated separately for dominant and nondominant sides, and then, UV was compared between weight-bearing conditions on pooled dominant/nondominant data.</div></div><div><h3>Results</h3><div>Pooled analyses comparing weight-bearing conditions revealed a significant increase in UV for H versus N (0.58 mm) and P versus N (1.00 mm), but no significant change in UV for H versus P (0.43 mm). Significant differences in UV were detected for H versus N, P versus N, and H versus P for dominant and nondominant extremities. The change from N to H was significantly greater in the dominant versus nondominant side, but greater in the nondominant side from N to P.</div></div><div><h3>Conclusions</h3><div>Ulnar variance changed with the application of load and position of the wrist. Differences in UV were found between dominant and nondominant extremities.</div></div><div><h3>Clinical relevance</h3><div><span>Upper extremity loading patterns are affected by hand dominance as defined by a cartwheel and suggest skeletal consequences from repetitive load on a dominantly used wrist. Although statistically significant, subtle changes detected in this investigational study do not necessarily bear clinical significance. Future WBCT research can lead to improved </span>diagnostic measures for wrist pathologies affected by active loading and rotational wrist behavior.</div></div>","PeriodicalId":54815,"journal":{"name":"Journal of Hand Surgery-American Volume","volume":"50 4","pages":"Pages 498.e1-498.e8"},"PeriodicalIF":2.1000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hand Surgery-American Volume","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0363502323005026","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose
Ulnar variance (UV) is a radiographic measurement relating the articular surface heights of the distal radius and ulna. Abnormal UV increases the risk for wrist pathology; however, it only provides a static measurement of an inherently dynamic bony relationship that changes with wrist position and loading. The purpose of this study was to investigate how full-body weight-bearing affects UV using weight-bearing computed tomography (WBCT).
Methods
Ten gymnasts completed two 45-second scans inside a WBCT machine while performing a handstand on a flat platform (H) and parallettes (P). A non–weight-bearing CT scan was collected to match clinical practice (N). Differences in UV between weight-bearing conditions were evaluated separately for dominant and nondominant sides, and then, UV was compared between weight-bearing conditions on pooled dominant/nondominant data.
Results
Pooled analyses comparing weight-bearing conditions revealed a significant increase in UV for H versus N (0.58 mm) and P versus N (1.00 mm), but no significant change in UV for H versus P (0.43 mm). Significant differences in UV were detected for H versus N, P versus N, and H versus P for dominant and nondominant extremities. The change from N to H was significantly greater in the dominant versus nondominant side, but greater in the nondominant side from N to P.
Conclusions
Ulnar variance changed with the application of load and position of the wrist. Differences in UV were found between dominant and nondominant extremities.
Clinical relevance
Upper extremity loading patterns are affected by hand dominance as defined by a cartwheel and suggest skeletal consequences from repetitive load on a dominantly used wrist. Although statistically significant, subtle changes detected in this investigational study do not necessarily bear clinical significance. Future WBCT research can lead to improved diagnostic measures for wrist pathologies affected by active loading and rotational wrist behavior.
期刊介绍:
The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.