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Related Experiment Videos

Normal disruption of carpal arcs

W C Peh1, L A Gilula

  • 1Department of Diagnostic Radiology, University of Hong Kong, Queen Mary Hospital, Hong Kong.

The Journal of Hand Surgery
|July 1, 1996
PubMed
Summary

Carpal arcs typically disrupt during radial and ulnar wrist deviation but remain intact in a neutral position. This finding is crucial for interpreting wrist instability on X-rays, especially concerning the scapholunate joint.

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Area of Science:

  • Orthopedics
  • Radiology
  • Anatomy

Background:

  • Carpal arcs are radiographic indicators used to assess wrist stability.
  • Previous assumptions suggested carpal arcs remain intact in neutral wrist positions.

Purpose of the Study:

  • To test the hypotheses that carpal arcs normally break in radial and ulnar deviation and remain intact in neutral positions.
  • To evaluate the reliability of carpal arcs in diagnosing wrist instability across different wrist orientations.

Main Methods:

  • Review of 100 asymptomatic wrist X-rays (posteroanterior and anteroposterior views).
  • Measurement of three carpal arcs (I, II, and III) in neutral, radial, and ulnar deviation.
  • Assessment of proximal-distal arc step-off to quantify disruption.

Main Results:

  • Carpal arcs I and II commonly disrupted in radial and ulnar deviation, contradicting the hypothesis of intact arcs.
  • Arc II disruption occurred frequently at the lunatriquetral and scapholunate joints during deviation.
  • Arcs I and II remained intact in the neutral position in most cases (4 exceptions).
  • Arc III remained intact in all tested positions and deviations.

Conclusions:

  • Radiographic carpal arcs normally disrupt with radial and ulnar deviation.
  • Interpretation of carpal arcs I and II, and scapholunate joint width, requires caution when the wrist is not in a neutral position.
  • Findings impact the diagnostic utility of carpal arcs in wrist instability assessment.

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