Distinct Wrist Patterns Founded on Measurements in Plain Radiographs

Kramer, Aviv; Allon, Raviv; Werner, Frederick W.; Lavi, Idit; Wolf, Alon; Wollstein, Ronit

doi:10.1055/s-0038-1660811

Cited by 4 publications

(3 citation statements)

References 27 publications

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“…These significantly included the length of capitate circumference in contact with the lunate and nearly significantly the percentage of capitate circumference in contact with the lunate. In a previous study, 21 the authors found a higher percentage of capitate circumference in contact with the lunate in type 1 wrists. No correlations were found with the measurements distal to the distal carpal row (trapezium and carpometacarpal row).…”

Section: Discussionmentioning

confidence: 73%

Midcarpal Structure Effect on Force Distribution through the Radiocarpal Joint

et al. 2019

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Background Wrist structure is complicated by distinct anatomical patterns. Previous studies defined radiographic wrist types based on lunate and capitate shape within the midcarpal joint. We hypothesized that these disparate structural patterns will transfer forces differently through the wrist. Objective This study aims to correlate force transferred to the distal radius and ulna with morphological measurements in cadaver arms. Methods Radiographs from 46 wrists, previously tested for force transfer between the radius and ulna, were examined. The percentage of compressive force through the distal ulna was determined by mounting load cells to the radius and ulna, while 22.2 Newton (N) tensile forces were individually applied to multiple tendons. Each wrist was tested in a neutral flexion–extension and radial-ulnar deviation position. Results Wrist type and lunate type were associated with percentage of force transfer through the ulna (p = 0.002, p = 0.0003, respectively). Percentage of force transfer was correlated with capitate circumference (p = 0.02, r = 0.34). Conclusions This study supports distinct force transfer between morphological wrist types. Clinical Relevance Understanding the mechanical significance of different structural variations in the wrist bones will improve our ability to understand wrist function and the distinctive development of wrist pathology. Level of Evidence This is a Level II study.

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Section: Discussionmentioning

confidence: 73%

Midcarpal Structure Effect on Force Distribution through the Radiocarpal Joint

et al. 2019

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“…• Percent (capitate circumference) that articulates with the base of the index and middle and ring metacarpal bones is measured. The measurements were based on previous studies 4,8 The second part consists of generating a 3D model of the wrist midcarpal joint using finite element analysis, as follows.…”

Section: Methodsmentioning

confidence: 99%

“…2,3 The structure of the midcarpal joint has been divided into two structural patterns: a type 1 wrist that has a lunate type 1 and spherical proximal capitate, and a type 2 wrist with a type 2 lunate and flat proximal capitate. 4,5 This variation has been shown to affect load transfer in between the ulna and radius. 6 Assuming that these structural disparities will affect load transfer through the midcarpal joint, the purpose of this study was to:…”

Section: Introductionmentioning

confidence: 99%

A Preliminary Model of the Wrist Midcarpal Joint

2021

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Background A challenge to deciphering the effect of structure on function in the wrist involves difficulty in obtaining in-vivo information. To provide a platform to study wrist mechanics using in vivo acquired forces, we developed a model of the midcarpal joint based on computed tomography (CT) scans of normal wrists. Finite element analysis (FEA) can enable application of in vivo collected information to an ex vivo model. Objectives The objectives of this study are to (1) create a three-dimensional model of the midcarpal joint of the wrist based on CT scans and (2) generate separate models for the midcarpal joint based on two distinct wrist types and perform a pilot loading of the model. Methods CT scans from a normal patient database were converted to three-dimensional standard template library (STL) files using OsiriX software. Five type 1 and five type 2 wrists were used for modeling. A simulated load was applied to the carpometacarpal joints in a distal-to-proximal direction, and FEA was used to predict force transfer in the wrist. Results There were 33% type 1 and 67% type 2 wrists. The midcarpal joint dimensional measurements estimated from the model had intermediate agreement between wrist type as measured on CT scan and as predicted by the model: 56% Cohen's kappa (95% confidence interval) = 0.221 (0.05–0.5). Surface stress on the carpometacarpal joints is different in type 1 and type 2 wrists. On loading the neutral wrist, the capitolunate angle was 90 degrees in type 1 wrists and 107 degrees in type 2 wrists (p < 0.0001). Conclusions The model predicted differences in movement and force transfer through the midcarpal joint dependent on structural type. This knowledge can improve our understanding of the development of disparate patterns of degeneration in the wrist.

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Translation of 2-Dimensional Wrist Radiographic Measurements to 3-Dimensional CT Scans

Wollstein

Kramer

Babb

et al. 2020

J Hand Surg Asian-Pac Vol

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Background: Anatomical structure affects function. The morphology of articulations dictates the way forces will travel through the joint. A better understanding of the structure and function of the wrist will enhance our ability to diagnose and treat wrist conditions. Two wrist types have been described based on the morphology of the midcarpal joint. Biomechanically it is important to see if these 2-dimensional (2D) observations reflect articular contact areas. Our purpose was to assess the correlation between measurements performed on wrist radiographs (2D) to measurements performed on 3-dimensional (3D) computed tomography (CT). Methods: Retrospective review of a database of normal wrist radiographs and corresponding normal CT scans. Only imaging pairs with normal carpal alignment and technically optimal imaging were included. Evaluations included lunate, capitate and wrist type, capitate circumference, percent capitate circumference and volume that articulates with the lunate, scapholunate ligament, scaphoid, hamate, trapezoid, base of the index and middle and ring metacarpal bones. Results: Midcarpal joint radiographic measurements were positively correlated with measurements on CT scans. Correlations were 0.51 for capitate type and 0.71 for lunate type with both p < 0.001. Percent contact of the lunate with the hamate: r was 0.74 p < 0.001. Using logistic regression analysis, percent lunate-hamate contact on CT was a significant predictor of radiographic lunate type 2 p < 0.001. Percent contact area between lunate and hamate > 7.8% on CT scan achieved a sensitivity of 100% and specificity 79.4% for a type 2 lunate. Conclusions: 1) Good correlations found between CT and plain radiographs in lunate type, capitate type, and midcarpal joint contact support the use of plain radiographs to describe contact between the carpal bones in the clinical setting. 2) The retrospective nature of this study limited the technical quality of the measurements. Volumetric analysis may aid in a more exact evaluation of surface contact area.

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Distinct Wrist Patterns Founded on Measurements in Plain Radiographs

Cited by 4 publications

References 27 publications

Midcarpal Structure Effect on Force Distribution through the Radiocarpal Joint

Midcarpal Structure Effect on Force Distribution through the Radiocarpal Joint

A Preliminary Model of the Wrist Midcarpal Joint

Translation of 2-Dimensional Wrist Radiographic Measurements to 3-Dimensional CT Scans

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