Wrist Bone Motion during Flexion-Extension and Radial-Ulnar Deviation: An MRI Study

Abstract

The wrist joint plays a vital role in activities of daily living. Clinical applications, e.g., therapeutic planning, prosthesis design, and wrist biomechanical analysis, require a detailed understanding of wrist maneuvers and motion. The lack of soft tissue information, motion analysis on limited carpal bones, etc., restrain the investigation of wrist kinematics. In this study, we established 3D models of carpal bones with their cartilages, and revealed the helical axes (HA) of all eight carpal bones for the first time. Both left and right hands at different positions of flexion-extension (FE) and radial-ulnar deviation (RUD) from five subjects were in-vivo imaged through a magnetic resonance imaging device. We segmented all of the bones, including cartilage information in the wrist joint, after which we explored the kinematics of all carpal bones with the HA method. The results showed that the HA of all carpal bones for FE bounded tightly and was mainly located slightly above the radius. During the RUD, carpal bones in the distal row rotated along with wrist movement while the scaphoid, lunate, and triquetrum primarily flexed and extended. Further results reported that the carpal bones translated greater in RUD than in FE. With the generation of more delicate wrist models and thorough investigations of carpal motion, a better understanding of wrist kinematics was obtained for further pathologic assessment and surgical treatment.

Force Transfer through the Scaphotrapeziotrapezoid (STT) Joint

“…As such, bone-only models have been used in previously published literature. 12,13 Furthermore, since we are looking at patient-specific CT scans, we believe it would have compromised the models to include generic ligament placements. Especially since, as stated, much about the ligamentous structures remain unknown and variable between individual wrists (locations of insertions, physical properties, etc.).…”