J Wrist Surg 2018; 07(05): 366-374
DOI: 10.1055/s-0038-1660811
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Distinct Wrist Patterns Founded on Measurements in Plain Radiographs

Aviv Kramer
1   School of Medicine, Technion Israel Institute of Technology, Haifa, Israel
,
Raviv Allon
1   School of Medicine, Technion Israel Institute of Technology, Haifa, Israel
,
Frederick Werner
2   Department of Orthopedic Surgery, SUNY Upstate Medical University, Syracuse, New York
,
Idit Lavi
3   Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
,
Alon Wolf
1   School of Medicine, Technion Israel Institute of Technology, Haifa, Israel
,
Ronit Wollstein
1   School of Medicine, Technion Israel Institute of Technology, Haifa, Israel
4   Department of Orthopedic Surgery, New York University, New York, New York
› Author Affiliations
Further Information

Publication History

16 September 2017

10 May 2018

Publication Date:
17 June 2018 (online)

Abstract

Background In joints, structure dictates function and consequently pathology. Interpreting wrist structure is complicated by the existence of multiple joints and variability in bone shapes and anatomical patterns in the wrist. Previous studies evaluated lunate and capitate shape in the midcarpal joint, and two distinct patterns have been identified.

Purpose Our purpose was to further characterize the two wrist patterns in normal wrist radiographs using measurements of joint contact and position. Our hypothesis was that we will find significant differences between the two distinct anatomical patterns.

Patients and Methods A database of 172 normal adult wrist posteroanterior (PA) radiographs was evaluated for radial inclination, height, length, ulnar variance, volar tilt, radial-styloid-scaphoid distance, and lunate and capitate types. We measured and calculated percent of capitate facet that articulates with the lunate, scapholunate ligament, scaphoid, and trapezoid. These values were compared between the wrist types and whole population.

Results Type-1 wrists (lunate type-1 and spherical proximal capitate) were positively associated with a longer facet between capitate and distal lunate (p = 0.01), capitate and base of middle metacarpal (p = 0.004), and shorter facet between the capitate and hamate (p = 0.004). The odds ratio of having a type-1 wrist when the interface between the capitate and lunate measures >8.5 mm is 2.71 (confidence interval [CI] 1.07, 6.87) and when the line between the capitate and the base of middle metacarpal >9.5 mm is 3.5 (CI 1.38, 9.03).

Conclusion We characterized the two-wrist patterns using intracarpal measurements. Translating these differences into three-dimensional contact areas may help in the understanding of biomechanical transfer of forces through the wrist.

Level of Evidence This is a Level II, diagnostic study.

Note

Institutional review board approval was obtained prior to the study commencement. The study was performed at the Technion Israel Institute of Technology.


 
  • References

  • 1 Murphy MC, Conner IP, Teng CY. , et al. Retinal structures and visual cortex activity are impaired prior to clinical vision loss in glaucoma. Sci Rep 2016; 6: 31464
  • 2 Sharma GB, McMahon PJ, Robertson DD. Structure modeling of the glenoid: relevance to shoulder arthroplasty. J Orthop Res 2014; 32 (11) 1471-1478
  • 3 Crisco JJ, Heard WM, Rich RR, Paller DJ, Wolfe SW. The mechanical axes of the wrist are oriented obliquely to the anatomical axes. J Bone Joint Surg Am 2011; 93 (02) 169-177
  • 4 Pulos N, Bozentka DJ. Carpal ligament anatomy and biomechanics. Hand Clin 2015; 31 (03) 381-387
  • 5 Gabra JN, Li ZM. Three-dimensional stiffness of the carpal arch. J Biomech 2016; 49 (01) 53-59
  • 6 Nagata J, Kojima Y, Satomura K, Ishiko T, Ajiki T. Anatomic variations of the flexor carpi radialis brevis: a report of five cases. J Hand Surg Asian Pac Vol 2016; 21 (01) 113-115
  • 7 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
  • 8 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
  • 9 Kramer A, Allon R, Wolf A, Kalaiman T, Lavi I, Wollstein R. Anatomical wrist patterns on plain radiographs. Curr Rheumatol Rev 2017
  • 10 Nakamura K, Patterson RM, Moritomo H, Viegas SF. Type I versus type II lunates: Ligament anatomy and presence of arthrosis. J Hand Surg Am 2001; 26 (03) 428-436
  • 11 Koh KH, Lee HI, Lim KS, Seo JS, Park MJ. Effect of wrist position on the measurement of carpal indices on the lateral radiograph. J Hand Surg Eur Vol 2013; 38 (05) 530-541
  • 12 Hardy DC, Totty WG, Reinus WR, Gilula LA. Posteroanterior wrist radiography: importance of arm positioning. J Hand Surg Am 1987; 12 (04) 504-508
  • 13 Mohammed Ali MH. A normal data-base of posteroanterior radiographic measurements of the wrist in healthy Egyptians. Surg Radiol Anat 2009; 31 (09) 665-674
  • 14 Wollstein R, Werner FW, Rubenstein R, Nacca CR, Bilonick RA, Gilula LA. Scaphoid translation measurements in normal wrists. Hand Surg 2013; 18 (02) 179-187
  • 15 Naran S, Zaulan Y, Shakir S, Gilula LA, Werner FW, Wollstein R. Radiographic assessment of ligamentous injuries in distal radius fractures after open reduction and internal fixation. Eur J Orthop Surg Traumatol 2014; 24 (07) 1151-1154
  • 16 Galley I, Bain GI, McLean JM. Influence of lunate type on scaphoid kinematics. J Hand Surg Am 2007; 32 (06) 842-847
  • 17 Viegas SF. The lunatohamate articulation of the midcarpal joint. Arthroscopy 1990; 6 (01) 5-10
  • 18 Yazaki N, Burns ST, Morris RP, Andersen CR, Patterson RM, Viegas SF. Variations of capitate morphology in the wrist. J Hand Surg Am 2008; 33 (05) 660-666
  • 19 Niacaris T, Ming BW, Lichtman DM. Midcarpal instability: a comprehensive review and update. Hand Clin 2015; 31 (03) 487-493
  • 20 Khan MS, Noordin S, Hashmi PM. Intra-articular distal radius fractures: postoperative roentgenographic and functional outcomes. J Pak Med Assoc 2016; 66 (03) 275-279
  • 21 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) 81-89
  • 22 Fraysse F, Costi JJ, Stanley RM. , et al. A novel method to replicate the kinematics of the carpus using a six degree-of-freedom robot. J Biomech 2014; 47 (05) 1091-1098
  • 23 Schweizer A, Mauler F, Vlachopoulos L, Nagy L, Fürnstahl P. Computer-assisted 3-dimensional reconstructions of scaphoid fractures and nonunions with and without the use of patient-specific guides: early clinical outcomes and postoperative assessments of reconstruction accuracy. J Hand Surg Am 2016; 41 (01) 59-69
  • 24 Snel JG, Venema HW, Moojen TM, Ritt JP, Grimbergen CA, den Heeten GJ. Quantitative in vivo analysis of the kinematics of carpal bones from three-dimensional CT images using a deformable surface model and a three-dimensional matching technique. Med Phys 2000; 27 (09) 2037-2047
  • 25 Evans P, Hoyen H, Sraj SA. Three-dimensional analysis of the proximal articulating surfaces of the lunate and capitate. J Hand Surg Eur Vol 2013; 38 (09) 1006-1007
  • 26 Canovas F, Roussanne Y, Captier G, Bonnel F. Study of carpal bone morphology and position in three dimensions by image analysis from computed tomography scans of the wrist. Surg Radiol Anat 2004; 26 (03) 186-190
  • 27 Niacaris T, Wong VW, Patel KM. , et al. Common radiographic imaging modalities fail to accurately predict capitate morphology. Hand (NY) 2015; 10 (03) 444-449