Three-dimensional carpal kinematics in vivo.
OBJECTIVE
The purpose of this study was to accurately quantify three-dimensional in vivo kinematics of all carpal bones in flexion and extension and radial and ulnar deviation.


METHODS
The right wrists of 11 healthy volunteers were imaged by spiral CT with rotational increments of 5 degrees during ulnar-radial deviation and of five of them also during flexion-extension motion. One regular-dose scan was used and the subsequent scans during wrist motion were performed with one-tenth of the regular dose. A three-dimensional matching technique using the internal structure of the bones was developed to trace the relative translations and rotations of the carpal bones very accurately.


RESULTS
Most of our results are in concordance with previously published in vitro data. We could, among others, substantiate proof to the statement that there is more than one kinematic pattern of the scaphoid. Furthermore, we could accurately describe small adaptive intercarpal motions in vivo of the distal carpal row.


CONCLUSIONS
To our knowledge, this is the first time the three-dimensional in vivo kinematics of all eight carpal bones is quantified accurately and non-invasively.


CONCLUSIONS
Kinematics of an injured wrist can be compared to these reference data. It may become possible that in this way a ligament lesion can be detected with high specificity and sensitivity, and that no other diagnostic modality will be needed. With these data we made animations with which the complex movements of the bones during different motions of the wrist can be viewed. In the future it may become possible that this analysis provides valuable information on the long-term results of operative interventions and possibly predicts results of operative techniques.
Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 Amsterdam-ZO, The Netherlands. moojen@nvpc.nl
T M
TM
Moojen
J G
JG
Snel
M J P F
MJ
Ritt
J M G
JM
Kauer
H W
HW
Venema
K E
KE
Bos
D000328:Adult; D001696:Biomechanical Phenomena; D002348:Carpal Bones / Q000502:physiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D012399:Rotation