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Does Wrist Laxity Influence Three-Dimensional Carpal Bone Motion?

Gordon M Best1, Michelle L Zec2, David R Pichora1

  • 1Department of Mechanical and Materials Engineering, Human Mobility Research Centre, Queen's University, 130 Stuart Street, Kingston K7 L 3N6, ON, Canada e-mail: .

Journal of Biomechanical Engineering
|January 7, 2018
PubMed
Summary
This summary is machine-generated.

Wrist laxity influences carpal bone motion. Decreased laxity in stiffer wrists shows altered scaphoid movement during radial-ulnar deviation, impacting wrist mechanics.

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Area of Science:

  • Orthopedics and Biomechanics
  • Hand and Wrist Surgery
  • Musculoskeletal Imaging

Background:

  • Previous studies on carpal mechanics yielded conflicting results regarding motion patterns (row-type vs. column-type) and their relation to wrist laxity.
  • Three-dimensional (3D) studies suggested consistent carpal bone motion across individuals, contrasting with earlier two-dimensional (2D) findings.

Purpose of the Study:

  • To investigate if carpal kinematics differ between wrists with varying laxity using 3D analysis.
  • To quantify the relationship between wrist laxity and the motion patterns of the scaphoid and lunate bones.

Main Methods:

  • Wrist laxity was measured using a goniometer to determine passive flexion-extension range of motion (ROM).
  • In vivo carpal kinematics of the scaphoid and lunate were captured using computed tomography (CT) scans in radial and ulnar deviation positions.
  • Motion was categorized as 'column-type' (flexion/extension during radial-ulnar deviation) or 'row-type' (radial-ulnar deviation during radial-ulnar deviation).

Main Results:

  • The scaphoid predominantly flexed and extended during wrist radial-ulnar deviation (RUD).
  • Subjects with decreased wrist laxity exhibited a greater component of scaphoid radial-ulnar deviation (RUD) during wrist RUD (R²=0.48, P<0.05).
  • Scaphoid posture in the neutral wrist position predicted wrist radial deviation (RD) ROM (R²=0.46, P<0.05).

Conclusions:

  • Ligament laxity plays a significant role in modulating proximal row carpal bone motion during wrist deviation.
  • Bone positioning in the neutral wrist may also influence carpal kinematics.
  • Understanding these kinematic variations can aid in developing patient-specific treatments for wrist pathologies.