title: In vivo 3-dimensional analysis of stage III Kienböck disease: pattern of carpal deformity and radioscaphoid joint congruity.
abstract: OBJECTIVE
  To examine 3-dimensional carpal alignment and radioscaphoid joint (RSJ) congruity among normal wrists and those with Lichtman stage III Kienböck disease or scapholunate dislocation (SLD).
  
  
  METHODS
  We conducted 3-dimensional analysis based on computed tomographic data to compare 10 wrists of stage III Kienböck disease (5 IIIa and 5 IIIb) with 5 normal wrists and 3 wrists with SLD. A markerless bone registration technique was used to investigate the 3-dimensional position of the scaphoid relative to the radius. To evaluate RSJ congruency, the inferred contact area between the scaphoid proximal pole and the distal radius was calculated from 3-dimensional bone models.
  
  
  RESULTS
  The scaphoid position was not significantly different from normal wrists in stage IIIa Kienböck disease. Stage IIIb Kienböck disease was meaningfully associated with a flexed scaphoid and proximal translation of the centroid, but not dorsal translation of the scaphoid proximal pole, where RSJ congruity was preserved. With SLD, the scaphoid flexed to the same extent as that in stage IIIb Kienböck disease, and the proximal pole translated dorsally together with the capitate, producing RSJ incongruity.
  
  
  CONCLUSIONS
  The patterns of carpal collapse differed between stage IIIb Kienböck disease and SLD in terms of RSJ congruity. Our study showed that stage IIIb Kienböck disease did not involve dorsal subluxation of the scaphoid proximal pole and that RSJ congruity was retained, unlike SLD.
  
  
  CONCLUSIONS
  Our results suggest that carpal collapse in Kienböck disease is not associated with RSJ incongruity, which may explain why there are asymptomatic patients with Kienböck disease and carpal collapse.
authors.affiliation: Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Yamada-oka, Suita; Department of Orthopedic Biomaterial Science, Osaka University Graduate School of Medicine, Yamada-oka, Suita; Department of Physical Therapy, Osaka Yukioka College of Health Science, Sojiji, Ibaraki-shi, Osaka; Department of Orthopedics, Nara Medical University, Kitayamato, Ikoma Nara, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kawanishi
authors.affiliation: Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Yamada-oka, Suita; Department of Orthopedic Biomaterial Science, Osaka University Graduate School of Medicine, Yamada-oka, Suita; Department of Physical Therapy, Osaka Yukioka College of Health Science, Sojiji, Ibaraki-shi, Osaka; Department of Orthopedics, Nara Medical University, Kitayamato, Ikoma Nara, Japan. Electronic address: moritomo@tcct.zaq.ne.jp.
authors.forename: Hisao
authors.initials: H
authors.lastname: Moritomo
authors.affiliation: Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Yamada-oka, Suita; Department of Orthopedic Biomaterial Science, Osaka University Graduate School of Medicine, Yamada-oka, Suita; Department of Physical Therapy, Osaka Yukioka College of Health Science, Sojiji, Ibaraki-shi, Osaka; Department of Orthopedics, Nara Medical University, Kitayamato, Ikoma Nara, Japan.
authors.forename: Shohei
authors.initials: S
authors.lastname: Omokawa
authors.affiliation: Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Yamada-oka, Suita; Department of Orthopedic Biomaterial Science, Osaka University Graduate School of Medicine, Yamada-oka, Suita; Department of Physical Therapy, Osaka Yukioka College of Health Science, Sojiji, Ibaraki-shi, Osaka; Department of Orthopedics, Nara Medical University, Kitayamato, Ikoma Nara, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Murase
authors.affiliation: Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Yamada-oka, Suita; Department of Orthopedic Biomaterial Science, Osaka University Graduate School of Medicine, Yamada-oka, Suita; Department of Physical Therapy, Osaka Yukioka College of Health Science, Sojiji, Ibaraki-shi, Osaka; Department of Orthopedics, Nara Medical University, Kitayamato, Ikoma Nara, Japan.
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Sugamoto
authors.affiliation: Department of Orthopedic Surgery, Osaka University Graduate School of Medicine, Yamada-oka, Suita; Department of Orthopedic Biomaterial Science, Osaka University Graduate School of Medicine, Yamada-oka, Suita; Department of Physical Therapy, Osaka Yukioka College of Health Science, Sojiji, Ibaraki-shi, Osaka; Department of Orthopedics, Nara Medical University, Kitayamato, Ikoma Nara, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Yoshikawa
mesh_terms: D000328:Adult; D002348:Carpal Bones / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D004204:Joint Dislocations / Q000000981:diagnostic imaging*; D012667:Lunate Bone / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000000981:diagnostic imaging*; D011884:Radius / Q000000981:diagnostic imaging*; D021361:Scaphoid Bone / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014955:Wrist Joint / Q000000981:diagnostic imaging*
keywords: 3-dimensional analysis; Kienböck disease; scaphoid rotatory subluxation; scapholunate dissociation