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Pisiform kinematics in vivo.

T M Moojen1, J G Snel, M J Ritt

  • 1Department of Plastic, Reconstructive, and Hand Surgery, Academic Medical Center, Amsterdam, The Netherlands.

The Journal of Hand Surgery
|September 19, 2001
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Summary

This study quantifies pisiform bone movement in the wrist during various motions. Findings reveal how the pisiform articulates with the triquetrum, offering insights into wrist joint mechanics and potential clinical conditions.

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Area of Science:

  • Orthopedics
  • Biomechanics
  • Anatomy

Background:

  • Understanding carpal bone kinematics is crucial for diagnosing and treating wrist injuries.
  • The pisiform bone's complex articulation with the triquetrum requires detailed in vivo analysis.

Purpose of the Study:

  • To quantify the in vivo kinematics of the pisiform bone during wrist radial-ulnar deviation and flexion-extension.
  • To establish a reference for normal pisiform motion.

Main Methods:

  • Spiral computed tomography (CT) was used to image the wrists of healthy volunteers (n=11 for deviation, n=5 for flexion-extension).
  • A 3-dimensional matching technique was employed to determine relative translations and rotations of carpal bones with sub-millimeter and sub-degree accuracy.
  • Registration error was less than 0.5 mm for translation and 0.4 degrees for rotation.

Main Results:

  • During radial deviation, the pisiform flexes while the triquetrum extends.
  • During ulnar deviation, the triquetrum exhibits increased ulnar deviation and extension.
  • In wrist extension, the pisiform translates distally over and is pressed against the triquetrum.
  • In wrist flexion, the pisiform moves proximally away from the triquetrum.

Conclusions:

  • The study provides quantitative in vivo data on pisiform kinematics during wrist motion.
  • These findings help explain clinical conditions like degenerative changes in the pisotriquetral joint.
  • The data serves as a valuable reference for normal pisiform bone movement.