Anatomical study of all carpal and adjoining bones of the wrist using 3D CT reconstruction –Finding the ultimate biomechanical theory

Gill, Dominik; Lyer, Stefan; Fried, Frederik W; Buder, Thomas; Neuhuber, Winfried; Jacxsens, Matthijs; Horch, Raymund E.; Arkudas, Andreas

doi:10.1016/j.aanat.2022.151909

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…Although the ligamentous structures of the wrist play a crucial role in guiding and containing carpal bone motion during overall movements of the wrist, assessing intact or ruptured wrist ligaments is not part of the standard clinical care [ 7 ]. However, previous ligamentous injury or disruption of the triangular fibrocartilage complex could influence the kinematics of the wrist leading to a different load pattern [ 7 , 8 ]. Nevertheless, we excluded patients with a previous fracture of the forearm since this could influence the shape of the wrist and ulna.…”

Section: Discussionmentioning

confidence: 99%

Morphological risk factors for scaphoid fracture: a case–control study

Cohen

Claessen²,

Berg

et al. 2022

Eur J Trauma Emerg Surg

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Purpose Most patients with a clinically suspected scaphoid fracture and normal initial radiograph are unnecessarily treated. Previously developed prediction rules using demographic and clinical risk are unable to accurately predict occult fractures. Adding other risk factors could enhance this. Therefore, we aim to explore if there are morphological risk factors of the wrist for sustaining a scaphoid fracture. Methods We retrospectively included adult patients with a clinically suspected scaphoid fracture between 2013 and 2019 in our case–control study. There were 82 patients with a scaphoid fracture and 158 patients with a wrist contusion. Morphological risk factors were identified using statistical shape modelling (SSM) and linear measurements. Independent wrist shape variations on posteroanterior and lateral radiographs were captured in modes using SSM. Associations between outcomes and a scaphoid fracture were explored using logistic regression and the reliability was assessed. Results Of the 15 posteroanterior modes and 8 lateral modes identified and linear measurements performed, 1 PA mode was associated with a scaphoid fracture (PA mode 4; OR 1.40, CI 1.04–1.93, p = 0.031). We described this mode as an ulna plus and narrower distal radius with more volar tilt and radial inclination. The reliability of the posteroanterior modes and linear measurements was mostly good/excellent and moderate/poor for the lateral modes. Conclusion There was one complex wrist shape significantly associated with a scaphoid fracture. Since the association was weak and the shape is difficult to identify radiographs, we believe this morphological risk factor would not enhance identifying occult scaphoid fractures in the future.

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Section: Discussionmentioning

confidence: 99%

Morphological risk factors for scaphoid fracture: a case–control study

Cohen

Claessen²,

Berg

et al. 2022

Eur J Trauma Emerg Surg

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Mapping wrist motion: 3D CT analysis after scapholunate ligament transection

Promny,

Gill,

Lyer

et al. 2024

Journal of Anatomy

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The injury of the scapholunate (SL) ligament is common in wrist traumas leading to pain and reduced wrist function. The wrist's unique joint design and possible underlying theories as the carpal row theory were subject to earlier investigations studying wrist kinematics. Nevertheless, a comprehensive understanding of how SL ligament injuries affect wrist biomechanics is still lacking. Through a quantitative analysis of carpal bone motion patterns, we evaluated the impact on wrist kinematics occurring after SL ligament injury. We conducted a study using computer tomography imaging to analyse wrist kinematics after SL ligament transection in 21 fresh‐frozen anatomical specimens. The collected data were then transformed into 3D models, employing both standardized global and object coordinate systems. The study encompassed the evaluation of rotation and translation for each individual carpal bone, as well as the ulna, and all metacarpal bones in reference to the radius. The study showed a significant increase in rotation towards palmar (p < 0.01), particularly notable for the scaphoid, following transection of the SL ligament during palmar flexion. Ulnar deviation did not significantly affect rotation or translation, and radial deviation also showed no significant changes in rotation or translation. The study highlights the significance of the SL ligament in wrist kinematics, revealing that SL ligament tears lead to changes in wrist motion. While we observed significant rotational changes for the scaphoid, other carpal bones showed less pronounced alterations, emphasizing the complexity of wrist biomechanics.

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Anatomical study of all carpal and adjoining bones of the wrist using 3D CT reconstruction –Finding the ultimate biomechanical theory

Cited by 2 publications

References 21 publications

Morphological risk factors for scaphoid fracture: a case–control study

Morphological risk factors for scaphoid fracture: a case–control study

Mapping wrist motion: 3D CT analysis after scapholunate ligament transection

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