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At least 19 recordsLinked to original sources
PubMed1997

Normal kinematics of carpal bones: a three-dimensional analysis of carpal bone motion relative to the radius.

Normal carpal kinematics were studied in 22 cadaver specimens using a biplanar radiography method. The kinematics of the trapezium, capitate, hamate, scaphoid, lunate, and triquetrum were determined during wrist motion in sagittal and coronal planes. The results were expressed using the concept of the screw displacement axis and converted to describe the magnitude of rotation about and translation along three axes (X-axis: pronation-supination axis, Y-axis: flexion-extension axis, and Z-axis: radial-ulnar deviation axis) commonly used for the wrist. The orientation of these axes is expressed relative to the radius. Within the proximal carpal row, considerable differences of carpal behavior around the Y-axis were observed during sagittal plane motion of the wrist. The scaphoid exhibited the greatest magnitude of rotation, and the lunate the least. The magnitude of rotation of the carpal bones around the X-axis during sagittal plane motion of the wrist was small. The proximal carpal bones exhibited some ulnar deviation in 60 degrees of wrist flexion. During coronal plane motion of the wrist, the magnitude of radial-ulnar deviation of the distal carpal bones was mutually similar and generally of a greater magnitude than that of the proximal carpal bones. The proximal carpal bones experienced some flexion during radial deviation of the wrist and extension during ulnar deviation of the wrist. Translation was generally minimal in all carpal bones throughout wrist motion. This study reports results from the largest cadaver wrist kinematics study completed to date. The accuracy of the current method was improved when compared to previous studies. A sufficient number of specimens to allow statistical comparison was used and minimal interspecimen variability was noted. This study enabled a precise description of quantitative analyses of normal carpal kinematics relative to the radius.

Adult↗
PubMed1998

[Embryology of the human carpal bones (triangular cartilage, central carpal bone, morphogenesis of the scaphoid)].

Wax reconstructions according to Born's methods were performed from serial 10-micron sections of the wrists of human embryos (B. Tardif) to study the triangular cartilage and central bone of the carpus. A subsequent morphological study of the adult scaphoid bone was conducted in the light of embryological data. The triangular cartilage was observed in 4 of 38 carpi of embryos with a craniocaudal length of 40 to 69 mm, flatten between the ulna and triquetrum, on the inferior surface of the mesenchymal bud of the triangular ligament. The central bone of the carpus is constant in the embryo, between the inferior surface of the radial chondrification centre, capitatum, trapezium and trapezoid. In one case, the two wrists of the same embryo presented two central nuclei, leading to the distinction of two different formations:--the constant C2 embryonic central bone, trapped between capitatum, trapezoid and trapezium, which participates in the constitution of the scaphoid by fusion with the radial chondrification centre;--the C1 central bone, a rare supernumerary bone in adults, close to the inferolateral angle of the lunatum, on the dorsal surface of the carpus. These embryological data support. Westoll's theory concerning the filiation of the thoracic limb since the fin of crossopterygians, with deviation of the mechanical axis related to the development of weightbearing on the ground. The scaphoid bone must to be assimilated to a cube, but to an irregular tetrahedron, composed of two inverted pyramids joined by their bases. The inferior pyramid, articulating with he trapezium, trapezoid and capitatum, is concerned by morphological variations of the bone, which can present variable configurations between the two extreme morphotypes: the massive type and the strangulated type. The inferior pyramid, constituting the scaphoid, is derived from the central cartilage and presents the same relations. Variations of the volume of this inferior part of the bone are related to the more or less marked regression of this chondrification centre of the embryonic carpus. These variations of the bone can be expressed in terms of a scaphoid index, by calculating the relationship between the greatest dimension and the width of the narrowed portion.

Adult↗
PubMed2005

Attritional rupture of the flexor digitorum profundus tendon to the index finger caused by accessory carpal bone in the carpal tunnel: a case report.

We describe a case of attritional rupture of a flexor digitorum profundus tendon to the right index finger in a 73-year-old man by an accessory carpal bone located on the palmar side of the capitate and triquetrum. The radial edge of the accessory carpal bone appeared to be the cause of the rupture. Excision of the accessory carpal bone, bridge tendon graft using the palmaris longus tendon, and early controlled mobilization after surgery led to a successful outcome.

Aged↗
PubMed1996

[The pisiform bone: sesamoid or carpal bone?].

In man, the pisiform bone occupies an unusual place among the carpal bones. It is situated in an anterior plane to the other bones, sheathed within the tendon of the flexor carpi ulnaris, and ossifying almost four years the last of the carpal bones. Many theories have tried to explain the presence of this "exceptional" bone: the first theory, proposed by Flower and Mivart, suggested the possibility that this bone could be a sesamoid. The second theory supposes a polydactyl hand, assuming that polydactyly preceded pentadactyly; the pisiform would then be a post-minimus vestigial bone according to Bardeleben. Finally, Gegenbauer and Gillies, proposed a primary pentadactyl hand in which the carpus would be composed of three proximal elements, generally two central, and five distal. The pisiform would either be a derivative of the central series, or a distinct element in the carpus. This last theory appears to be the most likely. The primary carpus would therefore have consisted of 12 bones arranged in 3 distinct rows, a proximal row of 3 bones, a central row of 4 bones, and a distal row of 5 bones. According to this theory, the most ulnar of the central would have been displaced to the medial limit of the carpus, to become the pisiform.

Animals↗
PubMed2005

[Vascularized bone graft in carpal bone reconstruction].

We report our experience of vascularized bone graft harvested from the volar aspect of the distal radius for carpal bone reconstruction. Thirty cadaveric dissections showed in all cases the volar carpal artery which born from the radial artery. Between 1994 to 2001, we treated 87 scaphoid non-unions with an average follow-up of 41 months (range 6 to 65 months). Union was obtained in 80 patients (92%) with an average delay of 8.6 weeks (range 6 to 24). Between 1994 to 2000 we treated 22 patients with a Kienbock's disease. A radius shortening was always added to the revascularization of lunate by this vascularized bone graft. Preoperative and postoperative MRI was systematically done. The average follow-up was 55 months (range 24 to 92 months). MRI showed healing with good revascularization in 16 cases (74%). Lesions of lunate were stabilized in five cases and we had one failure with secondary palliative procedure. This simple but meticulous technique needs only one approach and allows a sufficient revascularisation.

Adolescent↗
PubMed2006

Computed tomographic documentation of a comminuted fourth carpal bone fracture associated with carpal instability treated by partial carpal arthrodesis in an Arabian filly.

OBJECTIVE: To report treatment of a unilateral comminuted fourth carpal bone (C4) fracture associated with carpal instability by partial carpal arthrodesis (PCA) of the middle carpal joint (MCJ) and carpometacarpal joint (CMCJ). STUDY DESIGN: Case Report. ANIMALS: An 8-month-old Arabian filly. METHODS: A C4 slab fracture was diagnosed radiographically; however, fracture comminution was conclusively diagnosed after computed tomographic (CT) imaging. PCA of the MCJ and CMCJ was performed with 2 narrow dynamic compression plates. RESULTS: PCA provided appropriate carpal stability and correct limb alignment immediately after surgery. Complete bony fusion with substantial carpal flexion and no lameness at walk or light trot was observed 8 months after surgery. CONCLUSIONS: Carpal CT was successfully used to define fracture configuration after standard radiographic examination failed to delineate comminution. PCA was selected because of joint instability and lateral carpal collapse of MCJ and CMCJ and can be successfully used to treat comminuted C4 slab fractures associated with carpal instability. Moderate MCJ osteoarthritis without radiocarpal joint involvement allows pain-free, substantial carpal flexion and thus, return to low-level pleasure riding may be possible. CLINICAL RELEVANCE: CT imaging may more adequately characterize traumatic carpal bone injury, particularly, when carpal bone fracture configuration cannot be determined on standard radiographs. Early PCA of the MCJ and CMCJ is an useful alternative to treat comminuted C4 slab fractures that cannot be reconstructed.

Animals↗
PubMed1993

[Partial arthrodesis of the carpal bones in advanced carpal collapse in chronic scapho-lunar instability and following scaphoid pseudoarthrosis].

Degenerative arthritis of the wrist as a consequence of chronic scapho-lunate instability or chronic scaphoid non-union follows very specific patterns. Joint destruction occurs primarily in the radio-scaphoid and in the luno-capitate joints while the radio-lunar joint is preserved. Treatment by partial carpal fusion between capitate, scaphoid and lunate aims at reconstruction of correct length of the central column and restoration of normal carpal height by reducing the dorsiflexed lunate bone, thereby decompressing the painful radio-scaphoid joint. We have carried out the procedure in 21 cases. At follow up (19 months) 17 patients were free of pain and 4 patients experienced major improvement but had some residual pain. The mean range of motion of the wrist was 57 degrees, representing a loss of 34% of preoperative range of movement. Bony union was achieved in all cases. All patients returned to their former occupation. Partial carpal fusion for treatment of SLAC-wrist and scaphoid nonunion has proven successful with respect to pain relief and partial preservation of wrist motion avoiding complete fusion or arthroplasty of the wrist.

Adult↗
PubMed2001

Automatic bone age estimation based on carpal-bone image--a preliminary report.

BACKGROUND: Bone age (BA) estimation is one of the important applications of hand radiography in the area of pediatrics, especially for the diagnosis of endocrinological problems and growth disorders. BA estimation (BAE) is tedious, time-consuming and highly dependent upon the expert experience. Nowadays, most BAE standards are based on American standards, but there is no BAE standard for Taiwanese people. We attempt to construct a computerized BAE system to automate BAE and in the long run to build a BAE standard for Taiwanese. METHODS: Our BAE system is based on the carpal bone information. We propose a new 2-stage edge detection method for carpal bone feature extraction and a new method for locating the carpal bone region of interest. RESULTS: After the image is manually equalized, our BAE system can estimate the bone age automatically. The extracted carpal bone features were applied to three classifiers for age estimation: the weighted minimum distance, Bayes, and neural network classifiers. The Bayes and neural network classifiers had better results. In the 0.5-year tolerance case, they both had over 90% correct rate for both male and female training data. In the 1-year tolerance case, they could classify correctly for the male and female testing data. CONCLUSIONS: A computerized BAE system has been developed and some experiments have been conducted. It is found that the classifying results for 0.5-year tolerance are good and satisfactory.

Age Determination by Skeleton↗
PubMed1999

Effect of age, exercise and growth rate on bone mineral density (BMD) in third carpal bone and distal radius of Dutch Warmblood foals with osteochondrosis.

This study aimed a the determining bone mineral density (BMD) in the 3rd carpal bone and distal radius of foals age 5 and 11 months that had been subjected to different exercise regimens from birth until age 5 months. It was hypothesised that BMD would be greater in older animals, and that differences in exercise regimens before age 5 months would be associated with differences in BMD at both age 5 and 11 months. Epiphyseal bone tissue was available from 5 and 11 month old Warmblood foals bred from sires known to have radiographic evidence of osteochondrosis (OC). The foals were in a clinical trial which assessed the effect of exercise up to age 5 months on osteochondrosis (OC). Until age 5 months, foals were either box confined, box confined and sprint trained daily, or kept at pasture. Half the horses in each group were then confined together in a large stall, with access to pasture for 2 h daily, from age 6 to 11 months. BMD was assessed by dual x-ray absorptiometry in 4 areas of interest (AOIs) of excised third carpal bone (C3) and 5 in the distal radius. Volumetric BMD was determined in C3, only surface BMD was analysed in the radius. Across age groups, exercise had an effect on BMD in the mediodorsal and mediopalmar areas of C3. In the 5-month-old animals, the training exercise had similar effect to constant pasture exercise. In all AOIs, BMD was significantly greater in 11-month than in 5-month-old animals. Between age groups there was a difference in effect of exercise regimen before 5 months, in mediodorsal C3 and medial aspect of the radius, and the difference observed between exercise groups at age 5 months was no longer present in horses age 11 months, indicating no residual effect of early exercise. BMD was lower in the group with high OC scores. In the group of horses with the most severe OC, monthly growth rate did not fall uniformly with age over the first 5 months, as it did in groups with lower OC scores. It was concluded that exercise influenced significantly BMD at 5 months, suggesting that carefully designed training programmes to increase bone mineral could be employed in young animals. There was no residual effect at 11 months.

Absorptiometry, Photon↗
PubMed2005

Incomplete scapholunate and trapeziotrapezoid coalitions with an accessory carpal bone.

Coalitions of the carpal bones associated with accessory carpal bones are relatively uncommon. We present a case of scapholunate and trapeziotrapezoid incomplete coalition with a dorsally situated accessory bone between trapezium and trapezoideum. X-ray, computed tomography, and magnetic resonance imaging findings of the patient are discussed in light of the pertinent literature.

Adult↗
PubMed1992

[Resection of the proximal carpal bones versus partial arthrodesis in carpal instability].

Ten resections of the proximal row of carpal bones and 42 partial arthrodese were performed for carpal instability. Whenever possible, the authors prefer the second operation. This choice is often made during the operation and essentially depends on the presence of radio-scaphoid osteoarthritis and the condition of the cartilage of the head of the capitatum.

Arthrodesis↗
PubMed1992

Healing of full-thickness cartilage compared with full-thickness cartilage and subchondral bone defects in the equine third carpal bone.

The effect of lesion depth on the quality of third carpal bone cartilage repair was examined. A 1-cm diameter articular defect penetrating the calcified cartilage in one limb and the subchondral bone plate in the opposite limb was created in the radial facet of the third carpal bones. Clinical and xeroradiographic examinations were performed every 4 weeks until 4 months (3 horses) and 6 months (3 horses) after surgery. The synovial membrane, non-opposing articular surfaces and articular defects were examined grossly, histologically and histochemically. Grossly, deeper defects contained thicker, whiter tissue, but both joints contained generalised degenerative changes. Defects extending through calcified cartilage were filled deeply by fibrocartilage and superficially by fibrous connective tissue. Defects extending through subchondral bone were consistently filled with hyaline-like cartilage in the depths of the lesion, fibrocartilage in the intermediate layer and fibrous connective tissue superficially. The results indicate that subchondral bone is the source of hyaline-like cartilage repair tissue and suggest that quality of healing of cartilage defects may be improved by penetrating the subchondral bone plate. It also appears that the synovitis associated with the procedure must be controlled before the procedure can be advocated for treatment of clinical cases.

Animals↗
PubMed1999

Primary neoplasms of the carpal bones.

Primary neoplasms of the carpal bones are rare. We found 44 primary tumors of the carpal bones of 26,800 bone neoplasms (prevalence, 0.16%). Original histologic slides and original radiographs were reviewed in 36 and 29 cases, respectively. Thirty-eight tumors (86%) were benign; 6 (14%) were malignant. The average patient age was 35 years. Benign lesions were diagnosed at a younger age (32 years) than malignant lesions (58 years). Benign tumors occurred more frequently in males (23 of 38 patients); the 6 malignant lesions were equally distributed by gender (3 males and 3 females; 95% confidence interval, 11.8-88.2). The most common tumor was osteoid osteoma (11 cases); the most common malignant neoplasm was hemangioendothelial sarcoma (3). The most common locations were the scaphoid (13 cases) and capitate (10), which together accounted for 52% of all neoplasms. Tumors were identified in every carpal bone except the trapezium. The diagnosis of tumor in a carpal bone should be considered in the undiagnosed painful wrist, especially in younger patients without imaging abnormalities.

Adolescent↗
PubMed1999

Galloping exercise induces regional changes in bone density within the third and radial carpal bones of Thoroughbred horses.

This study was performed to test the hypothesis that a localised bone hypertrophy could occur within the subchondral cancellous architecture of the third and radial carpal bones. Using 2 levels of controlled and defined exercise, it was observed that a high intensity treadmill exercise protocol resulted in functional adaptation of the carpal bones. The increase in trabecular thickening and density was seen to be localised to those regions underlying common sites of cartilage degradation, the interface of the thickened trabeculae with the normal architecture in the third carpal bone was coincident with a common site of clinical fractures. The bone changes were determined both qualitatively on examination of slab radiographs and quantified by dual energy x-ray absorptiometry. The findings from this study are relevant to mechanical factors involved in the pathophysiology of joint degeneration. The potential clinical implications of this study are in relation to changes in the type and duration of exercise regimens used in training of equine athletes. The rapid response of bone to mechanical stimulation has implications in the longer term for localised cartilage degradation. Imaging techniques could be developed to monitor these early bone changes in the specific areas identified in this study and thus allow appropriate changes in training intensity to minimise subsequent damage to the articular surface.

Absorptiometry, Photon↗
PubMed1994

Cystic radio-lucency of carpal bones in haemodialysis patients. An early indicator of the onset of carpal tunnel syndrome.

Patients receiving haemodialysis for more than 10 years were selected for this study in order to clarify an apparent sequential association of cystic lesions of carpal bones and carpal tunnel syndrome. X-rays and computed tomographs of 138 hands of 69 patients revealed cystic radiolucency of carpal bones in 35% of the hands. Radiographs were classified into three groups: Group A--cyst growing, Group B--cyst not growing, and Group C--cyst absent. The prevalence of carpal tunnel syndrome was 100% (27/27) in Group A, 5.6% (1/18) in Group B, and 6.5% (6/93) in Group C. Growth of the cyst precedes the development of carpal tunnel syndrome by about 2 or 3 years. Growth of the bone cyst indicates that inflammation had already extended to the tenosynovium and median nerve. Cystic radio-lucency of the carpal bones appears to be a useful indicator of the onset of carpal tunnel syndrome.

Adult↗