Subscribe to RSS
A Preliminary Model of the Wrist Midcarpal Joint
Background A challenge to deciphering the effect of structure on function in the wrist involves difficulty in obtaining in-vivo information. To provide a platform to study wrist mechanics using in vivo acquired forces, we developed a model of the midcarpal joint based on computed tomography (CT) scans of normal wrists. Finite element analysis (FEA) can enable application of in vivo collected information to an ex vivo model.
Objectives The objectives of this study are to (1) create a three-dimensional model of the midcarpal joint of the wrist based on CT scans and (2) generate separate models for the midcarpal joint based on two distinct wrist types and perform a pilot loading of the model.
Methods CT scans from a normal patient database were converted to three-dimensional standard template library (STL) files using OsiriX software. Five type 1 and five type 2 wrists were used for modeling. A simulated load was applied to the carpometacarpal joints in a distal-to-proximal direction, and FEA was used to predict force transfer in the wrist.
Results There were 33% type 1 and 67% type 2 wrists. The midcarpal joint dimensional measurements estimated from the model had intermediate agreement between wrist type as measured on CT scan and as predicted by the model: 56% Cohen's kappa (95% confidence interval) = 0.221 (0.05–0.5). Surface stress on the carpometacarpal joints is different in type 1 and type 2 wrists. On loading the neutral wrist, the capitolunate angle was 90 degrees in type 1 wrists and 107 degrees in type 2 wrists (p < 0.0001).
Conclusions The model predicted differences in movement and force transfer through the midcarpal joint dependent on structural type. This knowledge can improve our understanding of the development of disparate patterns of degeneration in the wrist.
Received: 14 May 2020
Accepted: 10 March 2021
Article published online:
01 May 2021
© 2021. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
- 1 Shepherd J, Lutz LJ, Miller RS, Main DS. Patients presenting to family physicians after a fall: a report from the Ambulatory Sentinel Practice Network. J Fam Pract 1992; 35 (01) 43-48
- 2 Sandow MJ, Fisher TJ, Howard CQ, Papas S. Unifying model of carpal mechanics based on computationally derived isometric constraints and rules-based motion - the stable central column theory. J Hand Surg Eur Vol 2014; 39 (04) 353-363
- 3 Sandow MJ. 3D dynamic analysis of the wrist. Hand Surg 2015; 20 (03) 366-368
- 4 Kramer A, Allon R, Werner F, Lavi I, Wolf A, Wollstein R. Distinct wrist patterns founded on measurements in plain radiographs. J Wrist Surg 2018; 7 (05) 366-374
- 5 Viegas SF. The lunatohamate articulation of the midcarpal joint. Arthroscopy 1990; 6 (01) 5-10
- 6 Wollstein R, Kramer A, Friedlander S, Werner F. Midcarpal structure effect on force distribution through the radiocarpal joint. J Wrist Surg 2019; 8 (06) 477-481
- 7 Musa TH, Li W, Xiaoshan L. et al. Association of normative values of grip strength with anthropometric variables among students, in Jiangsu Province. Homo 2018; 69 (1–2): 70-76
- 8 Kramer A, Allon R, Wolf A, Kalimian T, Lavi I, Wollstein R. Anatomical wrist patterns on plain radiographs. Curr Rheumatol Rev 2019; 15 (02) 168-171
- 9 Pendola M, Cresta J, Castillo A, Kirsch T. Use of ferrule rings as stress dissipators in temporomandibular joint intramedullary implants: a finite element analysis study. J Long Term Eff Med Implants 2018; 28 (04) 327-334
- 10 Polovinets O, Wolf A, Wollstein R. Force transmission through the wrist during performance of push-ups on a hyperextended and a neutral wrist. J Hand Ther 2018; 31 (03) 322-330
- 11 Badida R, Garcia-Lopez E, Sise C, Moore D, Crisco J. An approach to robotic testing of the wrist using 3-D imaging and a hybrid control strategy. J Biomech Eng 2020; 142 (06) 064501
- 12 Abe S, Moritomo H, Oka K. et al. Three-dimensional kinematics of the lunate, hamate, capitate and triquetrum with type 1 or 2 lunate morphology. J Hand Surg Eur Vol 2018; 43 (04) 380-386
- 13 Rhee PC, Moran SL, Shin AY. Association between lunate morphology and carpal collapse in cases of scapholunate dissociation. J Hand Surg Am 2009; 34 (09) 1633-1639
- 14 Rhee PC, Jones DB, Moran SL, Shin AY. The effect of lunate morphology in Kienböck disease. J Hand Surg Am 2015; 40 (04) 738-744
- 15 Bain GI, Clitherow HD, Millar S. et al. The effect of lunate morphology on the 3-dimensional kinematics of the carpus. J Hand Surg Am 2015; 40 (01) 81-9.e1
- 16 McLean JM, Turner PC, Bain GI, Rezaian N, Field J, Fogg Q. An association between lunate morphology and scaphoid-trapezium-trapezoid arthritis. J Hand Surg Eur Vol 2009; 34 (06) 778-782
- 17 Dibba B, Prentice A, Laskey MA, Stirling DM, Cole TJ. An investigation of ethnic differences in bone mineral, hip axis length, calcium metabolism and bone turnover between West African and Caucasian adults living in the United Kingdom. Ann Hum Biol 1999; 26 (03) 229-242
- 18 Viegas SF, Wagner K, Patterson R, Peterson P. Medial (hamate) facet of the lunate. J Hand Surg Am 1990; 15 (04) 564-571