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Sekiguchi T, Saito S, Ogura T, Tsuchiya A, Shiratsuchi H. Abnormal Wrist Sagittal Kinematics in Gymnasts With Dorsal Wrist Pain: A New Syndrome. Am J Sports Med 2024; 52:232-241. [PMID: 38164673 DOI: 10.1177/03635465231204361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND The pathology of dorsal wrist pain in gymnasts without abnormal radiographic findings remains unclear. PURPOSE/HYPOTHESIS The purpose of this study was to identify abnormal wrist sagittal kinematics in gymnasts with dorsal wrist pain. It was hypothesized that gymnasts with dorsal wrist pain would show abnormal sagittal kinematics with reversible hypermobility of the intercarpal joint. STUDY DESIGN Controlled laboratory study. METHODS Participants included 19 wrists in male gymnasts with dorsal wrist pain, 18 wrist in male gymnasts without wrist pain, and 20 adult men without a history of wrist pain. Magnetic resonance imaging (T2-weighted sagittal images) findings at 0°, 30°, 60°, and 90° of wrist extension were used in kinematic analysis. The angles and translations of the radiolunate, capitolunate, and third carpometacarpal joint were measured and compared between the 3 groups. RESULTS At 90° of wrist extension, gymnasts with dorsal wrist pain had a significantly lower radiolunate joint angle (28.70°± 6.28° vs 36.19°± 7.81°; P = .020) and a significantly higher capitolunate joint angle (57.99°± 6.15° vs 50.50°± 6.98°; P = .004) and distal translation (1.17 ± 0.50 mm vs 0.46 ± 0.62 mm; P = .002) than gymnasts without dorsal wrist pain. CONCLUSION Gymnasts with dorsal wrist pain showed abnormal wrist sagittal kinematics. These novel findings may facilitate understanding of dorsal wrist pain, which can be recognized as a new syndrome termed "gymnast's lunate dyskinesia."
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Affiliation(s)
- Takahiro Sekiguchi
- Department of Rehabilitation, Funabashi Orthopaedic Clinic, Funabashi, Chiba, Japan
| | - Shinobu Saito
- Japan Community Health care Organization (JCHO) Tokyo Joto Hospital, Koto-ku, Tokyo, Japan
| | - Takahiro Ogura
- Sports Medicine Center, Funabashi Orthopaedic Hospital, Funabashi, Chiba, Japan
| | - Akihiro Tsuchiya
- Sports Medicine Center, Funabashi Orthopaedic Hospital, Funabashi, Chiba, Japan
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Nadeem M, Loss JG, Li ZM, Seitz WH Jr. Ulnar Extension Coupling in Functional Wrist Kinematics During Hand Activities of Daily Living. J Hand Surg Am 2022; 47:187.e1-187.e13. [PMID: 34049729 DOI: 10.1016/j.jhsa.2021.03.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 01/24/2021] [Accepted: 03/24/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE Wrist circumduction is increasingly used as a functional motion assessment for patients. Thus, increasing our understanding of its relation to the functional motion envelope is valuable. Previous studies have shown that the wrist is preferentially extended during hand activities of daily living (ADLs), with greater ulnar than radial deviation. The purpose of this study was to characterize the functional wrist motions of 22 modern ADLs in healthy subjects. We hypothesized that the subjects would perform ADLs predominantly in ulnar extension. METHODS Ten right-handed, healthy subjects performed flexion-extension, radioulnar deviation, maximal circumduction, and 22 modern ADLs. Angular wrist positions were obtained by tracking retroreflective markers on the hand and forearm. Angular motion data were analyzed with a custom program for peak/trough angles in flexion extension and radioulnar deviation, ellipse area of circumduction data, and ellipse area of combined motion data. RESULTS The required ranges of motion for ADLs were from 46.6° ± 16.5° of flexion (stirring task) to 63.8° ± 14.2° of extension (combing) in flexion-extension and from 15.6° ± 8.9° of radial deviation (opening a jar) to 32.5° ± 8.3° of ulnar deviation (picking up smartphone) in radioulnar deviation. Ellipse area of combined motion data of the 22 ADLs were, on average, 58.2% ± 14.3% of the ellipse area of maximal circumduction. A motion data quadrantal analysis revealed that 54.9% of all ADL wrist motion occurred in ulnar extension. Among the average wrist positions for 22 ADLs, 16 were located in the ulnar extension quadrant. CONCLUSIONS This study revealed a functional wrist motion envelope that was less than 60% of wrist maximal motion capacity on average. Our results also showed that the majority of ADLs are performed in ulnar extension of the wrist. CLINICAL RELEVANCE Baseline values for healthy subjects performing 22 wrist ADLs can inform future studies assessing dysfunction, postsurgical changes, and rehabilitation progress.
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Suzuki T, Terasaka Y, Tomoyuki K, Hagiwara T, Masuda S, Kimura H, Matsumura N, Iwamoto T. Change of wrist motion before and after fixation of the distal radioulnar joint and resection of the distal ulna in a cadaveric model. Mod Rheumatol 2022; 32:136-140. [PMID: 33813991 DOI: 10.1080/14397595.2021.1910175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/25/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Recent study suggests the distal radioulnar joint (DRUJ) plays a role in flexion and extension of the wrist. We examined the range of motion (ROM) of the wrist before and after DRUJ fixation and distal ulnar resection in a cadaveric model. METHODS Twenty fresh cadaveric human wrists were transected and treated with two sequential interventions: (a) DRUJ fixation, and (b) distal ulnar resection. The angle of maximum flexion and extension of the wrist was measured before and after the procedures. Maximum force to the wrist was determined before the procedures using a digital pressure monitor. RESULTS The mean maximum wrist flexion ROM was 84.2° before the procedures. The ROM decreased to 82.5° after DRUJ fixation, and significantly increased to 88.2° after subsequent resection of the distal ulna. The mean maximum wrist extension ROM before the procedures was 73.5°. The ROM decreased to 71.6° after DRUJ fixation, and significantly increased to 77.1° after subsequent resection of the distal ulna. CONCLUSIONS Motion of the wrist is affected by DRUJ. This study suggests that the DRUJ might contribute to the ROM in flexion and extension of the wrist.
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Affiliation(s)
- Taku Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yukinori Terasaka
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kato Tomoyuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takeshi Hagiwara
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shusuke Masuda
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroo Kimura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Noboru Matsumura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takuji Iwamoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
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Suzuki T, Hayakawa K, Nakane T, Inaba N, Matsumura N, Sato K, Iwamoto T. Motion of the distal radioulnar joint in extension and flexion of the wrist using axial CT imaging of healthy volunteers. J Orthop Sci 2021; 26:610-615. [PMID: 32948406 DOI: 10.1016/j.jos.2020.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The midcarpal joint and the radiocarpal joint contribute to the extension and flexion of the wrist. Little is known about the contribution of the distal radioulnar joint (DRUJ) to the extension and flexion of the wrist. This study evaluated the ulnar motion in extension and flexion of the wrist using computed tomography (CT) imaging. METHODS A total of 30 wrists of healthy volunteers were enrolled. CT images of the axial sections of the DRUJ were obtained with 3 different positions of the wrist: 0° of extension (straight position), maximum active extension, and maximum active flexion. Each wrist motion was performed with 3 different forearm positions: neutral, pronation, and supination. Ulnar position at the DRUJ level was measured and ulnar position with the wrist in straight position was defined as baseline. The ulnar position was recorded as positive value when the position of the ulnar head was volar side and negative value when the position of the ulnar head was dorsal side. The difference from baseline in a position of maximum extension and flexion was evaluated. RESULTS In forearm neutral position and pronation, a value of ulnar position in maximum wrist flexion is significantly negative compared to that in the wrist straight position: the ulnar head moved dorsally from the wrist straight position to wrist flexion. In forearm supination, a value of ulnar position in maximum wrist extension is significantly positive compared to that in the wrist straight position: the ulnar head moved to the volar side from the wrist straight position to wrist extension. CONCLUSIONS The ulnar head moves during extension and flexion of the wrist. The direction of the ulnar motion was different according to the wrist and forearm position.
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Affiliation(s)
- Taku Suzuki
- Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinano-machi, Shinjuku, Tokyo, 160-8582, Japan.
| | - Katsuhiko Hayakawa
- Aiko Orthopaedic Surgery, 1221 Jinmyo, Okehazama, Midori-ku, Nagoya, Aichi, 458-0919, Japan
| | - Takashi Nakane
- Aiko Orthopaedic Surgery, 1221 Jinmyo, Okehazama, Midori-ku, Nagoya, Aichi, 458-0919, Japan
| | - Naoto Inaba
- Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinano-machi, Shinjuku, Tokyo, 160-8582, Japan
| | - Noboru Matsumura
- Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinano-machi, Shinjuku, Tokyo, 160-8582, Japan
| | - Kazuki Sato
- Institute for Integrated Sports Medicine, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takuji Iwamoto
- Department of Orthopaedic Surgery, School of Medicine, Keio University, 35 Shinano-machi, Shinjuku, Tokyo, 160-8582, Japan
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Kato T, Suzuki T, Kameyama M, Okazaki M, Morisawa Y, Nishiwaki M, Nakamura T, Sato K, Iwamoto T. Range of Motion after the Sauvé-Kapandji and Darrach Procedures without Extensor Tendon Rupture. J Wrist Surg 2021; 10:190-195. [PMID: 34109060 PMCID: PMC8169168 DOI: 10.1055/s-0040-1721452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/28/2020] [Indexed: 10/22/2022]
Abstract
Background Previous study demonstrated that distal radioulnar joint (DRUJ) plays a biomechanical role in extension and flexion of the wrist and suggested that fixation of the DRUJ could lead to loss of motion of the wrist. Little is known about the pre- and postoperative range of motion (ROM) after the Sauvé-Kapandji (S-K) and Darrach procedures without tendon rupture. To understand the accurate ROM of the wrist after the S-K and Darrach procedures, enrollment of patients without subcutaneous extensor tendon rupture is needed. Purpose This study aimed to investigate the pre- and postoperative ROM after the S-K and Darrach procedures without subcutaneous extensor tendon rupture in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Methods This retrospective study included 36 patients who underwent the S-K procedure and 10 patients who underwent the Darrach procedure for distal radioulnar joint disorders without extensor tendon rupture. Pre- and postoperative ROMs after the S-K and Darrach procedures were assessed 1 year after the surgery. Results In the S-K procedure, the mean postoperative ROM of the wrist flexion (40 degrees) was significantly lower than the mean preoperative ROM (49 degrees). In wrist extension, there were no significant differences between the mean preoperative ROM (51 degrees) and postoperative ROM (51 degrees). In the Darrach procedure, the mean postoperative ROM of the wrist flexion and extension increased compared with the mean preoperative ROM; however, there were no significant differences. Conclusion In the S-K procedure, preoperative ROM of the wrist flexion decreased postoperatively. This study provides information about the accurate ROM after the S-K and Darrach procedures. Level of Evidence This is a Level IV, therapeutic study.
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Affiliation(s)
- Tomoyuki Kato
- Department of Orthopaedic Surgery, Ogikubo Hospital, Suginami-ku, Tokyo, Japan
| | - Taku Suzuki
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Makoto Kameyama
- Department of Orthopaedic Surgery, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Masato Okazaki
- Department of Orthopaedic Surgery, Ogikubo Hospital, Suginami-ku, Tokyo, Japan
| | - Yasushi Morisawa
- Department of Orthopaedic Surgery, National Hospital Organization Saitama Hospital, Wako, Saitama, Japan
| | - Masao Nishiwaki
- Department of Orthopaedic Surgery, Kawasaki Municipal Hospital, Kawasaki, Japan
| | - Toshiyasu Nakamura
- Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare, Tokyo, Japan
| | - Kazuki Sato
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takuji Iwamoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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Abstract
AbstractThe hand-wrist region is reported as the most common injury site in boxing. Boxers are at risk due to the amount of wrist motions when impacting training equipment or their opponents, yet we know relatively little about these motions. This paper describes a new method for quantifying wrist motion in boxing using an electromagnetic tracking system. Surrogate testing procedure utilising a polyamide hand and forearm shape, and in vivo testing procedure utilising 29 elite boxers, were used to assess the accuracy and repeatability of the system. 2D kinematic analysis was used to calculate wrist angles using photogrammetry, whilst the data from the electromagnetic tracking system was processed with visual 3D software. The electromagnetic tracking system agreed with the video-based system (paired t tests) in both the surrogate (< 0.2°) and quasi-static testing (< 6°). Both systems showed a good intraclass coefficient of reliability (ICCs > 0.9). In the punch testing, for both repeated jab and hook shots, the electromagnetic tracking system showed good reliability (ICCs > 0.8) and substantial reliability (ICCs > 0.6) for flexion–extension and radial-ulnar deviation angles, respectively. The results indicate that wrist kinematics during punching activities can be measured using an electromagnetic tracking system.
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Padmore CE, Stoesser H, Nishiwaki M, Gammon B, Langohr GDG, Lalone EA, Johnson JA, King GJW. The Effect of Dorsally Angulated Distal Radius Deformities on Carpal Kinematics: An In Vitro Biomechanical Study. J Hand Surg Am 2018; 43:1036.e1-8. [PMID: 29573895 DOI: 10.1016/j.jhsa.2018.02.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 01/11/2018] [Accepted: 02/13/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose was to quantify the effect of distal radius dorsal angulation (DA) on carpal kinematics and the relative roles of the radiocarpal and midcarpal joints during wrist motion. METHODS Six cadaveric specimens (69 ± 17 y) were mounted at 90° elbow flexion in a custom wrist motion simulator. The wrist was guided through planar passive flexion and extension motion trials (∼ 5°/s). A custom modular distal radius implant was used to simulate native alignment and 3 distal radius DA deformities (10°, 20°, 30°). An optical tracking system captured carpal bone motion, from which radiocarpal and midcarpal joint motion was determined. RESULTS The radiocarpal joint made a greater contribution to wrist motion than the midcarpal joint in flexion, and the midcarpal joint made a greater contribution to motion than the radiocarpal joint in wrist extension. Increasing DA caused the radiocarpal joint contribution to increase throughout the motion arc, with the effect being more pronounced in wrist flexion. Conversely, as DA increased, the midcarpal joint contributed less rotation to the total wrist motion and its overall motion arc decreased; the magnitude of effect was greater in wrist extension. Dorsal angulation resulted in increased lunate flexion with respect to the distal radius. CONCLUSIONS Our findings agree with current literature that suggests that, in an uninjured wrist, the radiocarpal joint predominates flexion, and the midcarpal joint predominates extension. In addition, the radiocarpal joint has an amplified contribution in wrist flexion with greater DA malunion. CLINICAL RELEVANCE The altered contributions of the radiocarpal and midcarpal joints may contribute to pain, stiffness, and the development of arthritis, which is commonly seen at the radiocarpal joint after malunion of the distal radius.
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Abstract
Neither the complex motions of the scapholunate joint, nor the kinematic changes that occur as a result of injury to it, are fully understood. We used electromagnetic tracking within affected bones to evaluate the physiologic motions in the planes of flexion and extension, and of radial and ulnar deviation of human cadaver wrists, before and after complete transection of the scapholunate ligaments. Despite individual variance between each wrist, we were able to establish a pattern in the changes that occurred after scapholunate ligament injury. During the motions examined, the scaphoid showed an increase in translational deviation in almost all motion axes. In contrast, the movement of the lunate seemed to be impaired, especially in radial-ulnar deviation.
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Affiliation(s)
- J P Stromps
- 1 Department of Plastic Surgery, Hand Surgery, Burn Center, University Hospital RWTH Aachen, Aachen, Germany
| | - J Eschweiler
- 2 Chair of Medical Engineering, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany.,3 Department of Orthopedic Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - M Knobe
- 4 Department of Orthopedic Trauma, University Hospital RWTH Aachen, Aachen, Germany
| | - H O Rennekampff
- 1 Department of Plastic Surgery, Hand Surgery, Burn Center, University Hospital RWTH Aachen, Aachen, Germany
| | - K Radermacher
- 2 Chair of Medical Engineering, Helmholtz Institute for Biomedical Engineering, RWTH Aachen University, Aachen, Germany
| | - N Pallua
- 1 Department of Plastic Surgery, Hand Surgery, Burn Center, University Hospital RWTH Aachen, Aachen, Germany
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Mat Jais I, Tay S. Kinematic analysis of the scaphoid using gated four-dimensional CT. Clin Radiol 2017; 72:794.e1-794.e9. [DOI: 10.1016/j.crad.2017.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 03/24/2017] [Accepted: 04/03/2017] [Indexed: 11/27/2022]
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Fontaine C, Bry R, Laronde P, Guerre E, Aumar A. [Descriptive, radiographic, topographic and functional anatomy applied to distal radius fractures]. Hand Surg Rehabil 2016; 35S:S3-S14. [PMID: 27890208 DOI: 10.1016/j.hansur.2016.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 06/17/2016] [Accepted: 07/04/2016] [Indexed: 10/20/2022]
Abstract
Extensive anatomical knowledge is needed in order to correctly treat distal radius fractures: normal and pathological osteology of the distal radius, distal radio-ulnar joint and radiocarpal joint-both on the descriptive and functional level-the neurovascular and muscular environments of the distal radius-which are essential to the surgical approaches-and the angles that need to be restored during the reduction. All of these concepts are broached in this article.
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Affiliation(s)
- C Fontaine
- Service d'orthopédie B, hôpital Roger-Salengro, rue Émile-Laine, 59037 Lille cedex, France; Laboratoire d'anatomie, faculté de médecine de Lille, 1, place de Verdun, 59045 Lille cedex, France; Laboratoire d'automatique, de mécanique et d'informatique industrielle et humaine (LAMIH), université de Valenciennes et du Hainaut-Cambrésis, Le-Mont-Houy, 59313 Valenciennes cedex, France.
| | - R Bry
- Laboratoire d'anatomie, faculté de médecine de Lille, 1, place de Verdun, 59045 Lille cedex, France; Laboratoire d'automatique, de mécanique et d'informatique industrielle et humaine (LAMIH), université de Valenciennes et du Hainaut-Cambrésis, Le-Mont-Houy, 59313 Valenciennes cedex, France
| | - P Laronde
- Service d'orthopédie B, hôpital Roger-Salengro, rue Émile-Laine, 59037 Lille cedex, France; Laboratoire d'anatomie, faculté de médecine de Lille, 1, place de Verdun, 59045 Lille cedex, France
| | - E Guerre
- Service d'orthopédie B, hôpital Roger-Salengro, rue Émile-Laine, 59037 Lille cedex, France; Laboratoire d'anatomie, faculté de médecine de Lille, 1, place de Verdun, 59045 Lille cedex, France
| | - A Aumar
- Service d'orthopédie B, hôpital Roger-Salengro, rue Émile-Laine, 59037 Lille cedex, France; Laboratoire d'anatomie, faculté de médecine de Lille, 1, place de Verdun, 59045 Lille cedex, France
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Abstract
We hypothesized that wrist joint motion involves a "wrist rhythm" similar to the scapulohumeral rhythm. Therefore, we used a flat-panel detector to evaluate the ratio of radiolunate and capitolunate joint motions during wrist joint motion by dynamic radiography. The subjects were 20 healthy men. Dynamic imaging of the wrist joint was performed during active exercise for a total of ten seconds. In this study, we defined the radiocarpal (RL angle) and midcarpal joint angle (CL angle) as the wrist joint angle in the obtained images and measured the variation of these angles. The average curve was plotted and regression lines calculated from the average curve. The ratio was calculated from the slopes of the regression lines of the RL CL angles. These findings indicated that the ratio of the RL and CL angle motions was approximately 1:4 during palmar flexion and approximately 2:1 during dorsiflexion.
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Affiliation(s)
- Hiroki Kawashima
- Radiology Division, Kanazawa University Hospital, Division of Health Sciences, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
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Abstract
PURPOSE To validate the feasibility of real time kinematography with four-dimensional (4D) dynamic functional wrist joint imaging using dual source CT. MATERIALS AND METHODS Two healthy volunteers performed radioulnar deviation and pronation- supination wrist motions for 10 s and 4 s per cycle in a dual source CT scanner. Scan and reconstruction protocols were set to optimize temporal resolution. Cine images of the reconstructed carpal bone of the moving wrist were recorded. The quality of the images and radiation dosage were evaluated. RESULTS The 4D cine images obtained during 4 s and 10 s of radioulnar motion showed a smooth stream of movement with good quality and little noise or artifact. Images from the pronation-supination motion showed noise with a masked surface contour. The temporal resolution was optimized at 0.28 s. CONCLUSION Using dual source CT, 4D cine images of in vivo kinematics of wrist joint movement were obtained and found to have a shorter scan time, improved temporal resolution and lower radiation dosages compared with those previously reported.
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Affiliation(s)
- Yoon Seong Choi
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Young Han Lee
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Sungjun Kim
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Woo Cho
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Ho-Taek Song
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Jin-Suck Suh
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
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Gorniak GC, Conrad W, Conrad E, Decker B. Patterns of radiocarpal joint articular cartilage wear in cadavers. Clin Anat 2011; 25:468-77. [PMID: 22095798 DOI: 10.1002/ca.21258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 07/15/2011] [Accepted: 07/22/2011] [Indexed: 11/12/2022]
Abstract
The radiocarpal joint transmits about 80% of the compression forces crossing the wrist. However, primary osteoarthritis of this joint is surprisingly uncommon, suggesting that articular cartilage wear is not sufficient to produce arthritic symptoms. By examining the distal radius, scaphoid, and lunate in aged cadavers, wear patterns were charted and measured, allowing assessment of radiocarpal joint wear and mechanics. Bilateral radiocarpal joints of 16 females and 14 males (age 77.7 ± 14.4, N = 30) were exposed and measurements of the wear recorded microscopically. Wear locations were mapped, and X-Y loci and wear areas calculated. Gender right and sides compared. Over 95% of distal radius wear showed distinct radial-scaphoid and radial-lunate wear areas. These bilateral areas were in the palmar half of the distal radius. One main central wear area was seen in 95% of the scaphoid, and 97% of the lunate articular surfaces that were examined. Articular wear showed a circular pattern and was minimal in 95.7% of the surfaces, and the lunate showed the largest wear area. Wear patterns in males and females support the literature that for most ADLs the wrist is in slight extension and ulnar deviation. There are gender differences, but wear areas between sides were similar. Female wear indicates their wrist is positioned more often in a more extended and ulnarly deviated position than males. The wear patterns suggest rotational movements of the scaphoid and lunate during wrist motion and that the wrist is most often used in neutral flexion/extension to slight extension.
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Affiliation(s)
- Gerard C Gorniak
- University of St Augustine for Health Sciences, Institute of Physical Therapy, St Augustine, Florida 32086-5783, USA.
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Foumani M, Strackee S, Jonges R, Blankevoort L, Zwinderman A, Carelsen B, Streekstra G. In-vivo three-dimensional carpal bone kinematics during flexion–extension and radio–ulnar deviation of the wrist: Dynamic motion versus step-wise static wrist positions. J Biomech 2009; 42:2664-71. [DOI: 10.1016/j.jbiomech.2009.08.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 07/28/2009] [Accepted: 08/19/2009] [Indexed: 10/20/2022]
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Fischli S, Sellens R, Beek M, Pichora D. Simulation of extension, radial and ulnar deviation of the wrist with a rigid body spring model. J Biomech 2009; 42:1363-6. [DOI: 10.1016/j.jbiomech.2009.03.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2008] [Revised: 02/28/2009] [Accepted: 03/10/2009] [Indexed: 11/29/2022]
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Kai S, Yasumoto S, Takahashi S. Accessory Movement of the Lunate during Active Flexion and Extension Motion of the Wrist. J Phys Ther Sci 2006. [DOI: 10.1589/jpts.18.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Satoru Kai
- The School of Rehabilitation Sciences, International University of Health and Welfare
| | - Seiichi Yasumoto
- The School of Rehabilitation Sciences, International University of Health and Welfare
| | - Seiichiro Takahashi
- The School of Rehabilitation Sciences, International University of Health and Welfare
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Orr CM. Knuckle-walking anteater: a convergence test of adaptation for purported knuckle-walking features of African Hominidae. Am J Phys Anthropol 2005; 128:639-58. [PMID: 15861420 DOI: 10.1002/ajpa.20192] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Appeals to synapomorphic features of the wrist and hand in African apes, early hominins, and modern humans as evidence of knuckle-walking ancestry for the hominin lineage rely on accurate interpretations of those features as adaptations to knuckle-walking locomotion. Because Gorilla, Pan, and Homo share a relatively close common ancestor, the interpretation of such features is confounded somewhat by phylogeny. The study presented here examines the evolution of a similar locomotor regime in New World anteaters (order Xenarthra, family Myrmecophagidae) and uses the terrestrial giant anteater (Myrmecophaga tridactyla) as a convergence test of adaptation for purported knuckle-walking features of the Hominidae. During the stance phase of locomotion, Myrmecophaga transmits loads through flexed digits and a vertical manus, with hyperextension occurring at the metacarpophalangeal joints of the weight-bearing rays. This differs from the locomotion of smaller, arboreal anteaters of outgroup genera Tamandua and Cyclopes that employ extended wrist postures during above-branch quadrupedality. A number of features shared by Myrmecophaga and Pan and Gorilla facilitate load transmission or limit extension, thereby stabilizing the wrist and hand during knuckle-walking, and distinguish these taxa from their respective outgroups. These traits are a distally extended dorsal ridge of the distal radius, proximal expansion of the nonarticular surface of the dorsal capitate, a pronounced articular ridge on the dorsal aspects of the load-bearing metacarpal heads, and metacarpal heads that are wider dorsally than volarly. Only the proximal expansion of the nonarticular area of the dorsal capitate distinguishes knuckle-walkers from digitigrade cercopithecids, but features shared with digitigrade primates might be adaptive to the use of a vertical manus of some sort in the stance phase of terrestrial locomotion. The appearance of capitate nonarticular expansion and the dorsal ridge of the distal radius in the hominin lineage might be indicative of a knuckle-walking ancestry for bipedal hominins if interpreted within the biomechanical and phylogenetic context of hominid locomotor evolution.
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Affiliation(s)
- Caley M Orr
- Department of Anthropology, Institute of Human Origins, and NSF IGERT Program in Neural and Musculoskeletal Adaptation in Form and Function, Arizona State University, Tempe, Arizona 85287-2402, USA.
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Pfaeffle J, Blankenhorn B, Stabile K, Imbriglia J, Goitz R, Robertson D. Development and Validation of a Computed Tomography-Based Methodology to Measure Carpal Kinematics. J Biomech Eng 2005; 127:541-8. [PMID: 16060362 DOI: 10.1115/1.1894370] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Motion of the wrist bones is complicated and difficult to measure. Noninvasive measurement of carpal kinematics using medical images has become popular. This technique is difficult and most investigators employ custom software. The objective of this paper is to describe a validated methodology for measuring carpal kinematics from computed tomography (CT) scans using commercial software. Four cadaveric wrists were CT imaged in neutral, full flexion, and full extension. A registration block was attached to the distal radius and used to align the data sets from each position. From the CT data, triangulated surface models of the radius, lunate, and capitate bones were generated using commercial software. The surface models from each wrist position were read into engineering design software that was used to calculate the centroid (position) and principal mass moments of inertia (orientation) of (1) the capitate and lunate relative to the fixed radius and (2) the capitate relative to the lunate. These data were used to calculate the helical axis kinematics for the motions from neutral to extension and neutral to flexion. The kinematics were plotted in three dimensions using a data visualization software package. The accuracy of the method was quantified in a separate set of experiments in which an isolated capitate bone was subjected to two different known rotation/translation motions for ten trials each. For comparison to in vivo techniques, the error in distal radius surface matching was determined using the block technique as a gold standard. The motion that the lunate and capitate underwent was half that of the overall wrist flexion-extension range of motion. Individually, the capitate relative to the lunate and the lunate relative to the radius generally flexed or extended about 30 deg, while the entire wrist (capitate relative to radius) typically flexed or extended about 60 deg. Helical axis translations were small, ranging from 0.6 mm to 1.8 mm across all motions. The accuracy of the method was found to be within 1.4 mm and 0.5 deg (95% confidence intervals). The mean error in distal radius surface matching was 2.4 mm and 1.2 deg compared to the use of a registration block. Carpal kinematics measured using the described methodology were accurate, reproducible, and similar to findings of previous investigators. The use of commercially available software should broaden the access of researchers interested in measuring carpal kinematics using medical imaging.
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Affiliation(s)
- Jamie Pfaeffle
- Musculoskeletal Imaging and Biomechanics Laboratory, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA.
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Crisco JJ, Pike S, Hulsizer-Galvin DL, Akelman E, Weiss APC, Wolfe SW. Carpal bone postures and motions are abnormal in both wrists of patients with unilateral scapholunate interosseous ligament tears. J Hand Surg Am 2003; 28:926-37. [PMID: 14642507 DOI: 10.1016/s0363-5023(03)00422-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE The recent ability to measure 3-dimensional in vivo carpal kinematics has facilitated the noninvasive study of complex carpal bone motion. METHODS In this study we examined the flexion/extension carpal kinematics of both wrists in 8 patients with unilateral scapholunate interosseous ligament (SLIL) tears by using computed tomographic (CT) imaging and a markerless bone registration technique. Carpal bone neutral posture and flexion/extension motion of both wrists of the injured patients were compared with the same parameters in wrists of 10 uninjured male and female volunteers (normals). RESULTS The neutral posture of the injured scaphoid and lunate were significantly more extended than those of normals. In these patients, however, the postures of the scaphoid and lunate in the contralateral uninjured wrists also were abnormal and were similar to those of the injured wrist. In addition, extension of the lunate and flexion of the scaphoid in both the injured and uninjured wrist were significantly different from normal but not different from each other. CONCLUSIONS This study was unable to attribute altered carpal posture and motion to SLIL tears because abnormalities were found in both wrists of patients with unilateral injury. The etiology of abnormal wrist kinematics in the asymptomatic wrist of patients with unilateral tears of the scapholunate ligament is not known.
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Affiliation(s)
- Joseph J Crisco
- Department of Orthopaedics, Brown Medical School and Rhode Island Hospital, Providence, RI, USA
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Abstract
PURPOSE Techniques have been developed very recently with which it is possible to quantify accurately in vivo 3-dimensional (3-D) carpal kinematics. The aim of this study was to evaluate the feasibility of our novel 3-D registration technique by comparing our data with data found in the literature. METHOD The right wrists of 11 healthy volunteers were imaged by spiral computed tomography (CT) during radial-ulnar deviation and 5 of those wrists were imaged also during flexion-extension motion. With a matching technique relative translations and rotations of the carpal bones were traced. We compared our in vivo results with data presented in the literature. RESULTS We found our in vivo data largely to concur with in vitro data presented in the literature. In vivo studies revealed only larger out-of-plane motions within the proximal carpal row than described in most in vitro studies. In vivo studies also showed larger interindividual variations. CONCLUSIONS A single functional model of carpal kinematics could not be determined. We expect that in vivo 3-D CT studies on carpal kinematics, especially when applied to dynamic wrist motion, will have future diagnostic applications and provide information on long-term results of surgical interventions.
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Affiliation(s)
- Thybout M Moojen
- Departments of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, Amsterdam, The Netherlands
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