Capitate-based kinematics of the midcarpal joint during wrist radioulnar deviation: an in vivo three-dimensional motion analysis

Moritomo, Hisao; Murase, Tsuyoshi; Gotō, Akira; Oka, Kunihiro; Sugamoto, Kazuomi; Yoshikawa, Hideki

doi:10.1016/j.jhsa.2004.04.010

Cited by 86 publications

(67 citation statements)

References 27 publications

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“…The dart-thrower's plane of motion identified the transition between scaphoid and lunate flexion and extension, such that scaphoid and lunate motions were minimal along the dart-thrower's path of motion. Based on these findings, we agreed with Moritomo et al 27 that the dart-thrower's arc represents the most "stable and controllable" plane of motion in a kinematic sense, and represents the functional plane of wrist motion for most occupational and avocational activities.…”

supporting

confidence: 91%

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The Dart-Throwing Motion of the Wrist: Is It Unique to Humans?

Wolfe

Crisco

Orr

et al. 2006

The Journal of Hand Surgery

148

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Kinematic analysis has shown a near-stationary proximal carpal row during the dart-thrower's motion, which is believed to provide a stable platform for the generation of force and accuracy during certain power and precision grip activities. This finding is consistent with evidence in the human hand of adaptations that enabled effective manipulation of stones, cylindric wood, and bone tools for throwing and clubbing. There are at least two possible explanations for the observed human proximal carpal row kinematics. One is that it is retained from a previous common ancestor with great apes and previously adapted to some form of foraging or locomotor behavior involving the hands, but was recruited for tool use after we diverged from the apes. The second is that it evolved after our divergence from apes, in synchrony with adaptations in the human hand to the manipulation of tools, and central to the development of the human's unique ability to aim and accelerate tools and weapons. KeywordsDart-thrower's motion; wrist kinematics; human evolution; carpus; markerless bone registration This report details our understanding of the dart-thrower's motion in the context of carpal kinematic research and the implications that these kinematic findings have to human evolutionary development. We believe that a fundamental reshaping of our understanding of the planes of wrist motion and the functional arc of the human wrist may lead to advances in nonsurgical and surgical care of wrist injuries, implant design, and rehabilitation. Wrist Kinematics and the Dart-Thrower's ArcThe study of carpal kinematics is highly complex because of the irregular size and shape of the multiple small articulating surfaces and the complex forces that cross the wrist. Conclusions in the literature often are contradictory, and there is disagreement among leading investigators as to the direction of rotation and the contribution of individual carpal bones to global wrist motion. It generally is agreed that the proximal row moves in synchrony throughout radioulnar deviation and flexion-extension, but the degree of out-ofplane rotation and intercarpal motion within the proximal row is the source of considerable research efforts. 1-5 Both planar radiographic analyses and detailed 3-dimensional analyses

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supporting

confidence: 91%

“…The scaphoid and lunate were shown to flex and extend with little out-of-plane motion, regardless of the primary plane of wrist motion. Moritomo et al 27 used magnetic resonance imaging of the wrist in several positions of radioulnar deviation and showed that rotation was confined predominantly to the midcarpal joint during the dart-thrower's plane of motion.…”

mentioning

confidence: 99%

The Dart-Throwing Motion of the Wrist: Is It Unique to Humans?

Wolfe

Crisco

Orr

et al. 2006

The Journal of Hand Surgery

148

View full text Add to dashboard Cite

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“…This system has been used previously to study kinematics of the cervical spine, elbow, and wrist. [6][7][8][9] In the present study, we obtained MR images of the shoulder girdle in a seated position during arm abduction using a vertically open MRI. The purpose was to analyze the translation and rotational motion in the AC joint.…”

Section: Introductionmentioning

confidence: 99%

3D kinematic analysis of the acromioclavicular joint during arm abduction using vertically open MRI

Sahara

Sugamoto

Murai³

et al. 2006

J. Orthop. Res.

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Many researchers have evaluated the motions of the shoulder girdle, especially scapular and humeral motion. However, few reports exist that describe motions of the acromioclavicular joint. The purpose of the present study was to analyze the 3D kinematics of the acromioclavicular joint during arm abduction using 3D MR images obtained by a vertically open MRI. Fourteen shoulders of seven volunteers were examined in seven static positions from 08 to the maximum abduction in a seated position. 3D surface models of the clavicle and scapula were created, and the movements of the acromioclavicular joint from 08 to each position were calculated using the volume-based registration technique. From these calculations, the translations were evaluated and the rotational motions were analyzed using the concept of the screw axis. In the anteroposterior direction, the clavicle translated most posteriorly (À1.9 AE 1.3 mm) at 908 of abduction and most anteriorly (1.6 AE 2.7 mm) at maximum abduction. In the superoinferior direction, the clavicle translated slightly superiorly (0.9 AE 1.9 mm). When analyzing relative motion of the scapula with respect to the clavicle, the scapula generally rotated about a specific screw axis passing through the insertions of both the acromioclavicular and the coracoclavicular ligaments on the coracoid process. The average rotation was 34.9 AE 8.48. ß

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“…[17][18][19] However, oblique motion along the dart-thrower's arc from radial-extension toward ulnar-flexion has been proposed to represent an especially important functional plane of motion. 5,20,21 During testing, it was evident that whereas the purely coronal and sagittal wrist motion was markedly reduced after simulated RSL fusions, oblique motion along the dart-thrower's arc was preferentially preserved. This finding was expected given previous investigators consistently reporting that this arc uniquely involves minimal scaphoid and lunate motion.…”

Section: Discussionmentioning

confidence: 99%

“…This finding was expected given previous investigators consistently reporting that this arc uniquely involves minimal scaphoid and lunate motion. 5,6,7,20,22 As all previous outcomes studies after RSL fusions have only reported postoperative motion measured in the traditional orthogonal planes, it is possible that these measurements underestimate the remaining functional capacity of these wrists. 1,3,4,8,23 We were not able to detect a change in the orientation and location of the HAM axes of the capitate for flexion/extension after pinning.…”

mentioning

confidence: 99%

Simulated Radioscapholunate Fusion Alters Carpal Kinematics While Preserving Dart-Thrower's Motion

Calfee

Leventhal

Wilkerson

et al. 2008

The Journal of Hand Surgery

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Purpose-Midcarpal degeneration is well documented after radioscapholunate fusion. This study tested the hypothesis that radioscapholunate fusion alters the kinematic behavior of the remaining lunotriquetral and midcarpal joints, with specific focus on the dart-thrower's motion.Methods-Simulated radioscapholunate fusions were performed on 6 cadaveric wrists in an anatomically neutral posture. Two 0.060-in. carbon fiber pins were placed from proximal to distal across the radiolunate and radioscaphoid joints, respectively. The wrists were passively positioned in a custom jig toward a full range of motion along the orthogonal axes as well as oblique motions, with additional intermediate positions along the dart-thrower's path. Using a computed tomography-based markerless bone registration technique, each carpal bone's three-dimensional rotation was defined as a function of wrist flexion/extension from the pinned neutral position. Kinematic data was analyzed against data collected on the same wrist prior to fixation using hierarchical linear regression analysis and paired Student's t-tests.Results-After simulated fusion, wrist motion was restricted to an average flexion-extension arc of 48°, reduced from 77°, and radial-ulnar deviation arc of 19°, reduced from 33°. The remaining motion was maximally preserved along the dart-thrower's path from radial-extension toward ulnarflexion. The simulated fusion significantly increased rotation through the scaphotrapezial joint, scaphocapitate joint, triquetrohamate joint, and lunotriquetral joint. For example, in the pinned wrist, the rotation of the hamate relative to the triquetrum increased 85%. Therefore, during every 10° of total wrist motion, the hamate rotated an average of nearly 8° relative to the triquetrum after pinning versus 4° in the normal state.Conclusions-Simulated radioscapholunate fusion altered midcarpal and lunotriquetral kinematics. The increased rotations across these remaining joints provide one potential explanation for midcarpal degeneration after radioscapholunate fusion. Additionally, this fusion model confirms the dart-thrower's hypothesis, as wrist motion after simulated radioscapholunate fusion was primarily preserved from radial-extension toward ulnar-flexion. KeywordsCadaver; fusion; lunate; radius; scaphoid Degeneration of the radiocarpal joints is the end result of interrelated traumatic, inflammatory, and metabolic processes. Intra-articular distal radius fractures, perilunate Copyright © 2008 Nevertheless, RSL fusion is not without complication. Notably, published clinical outcomes after RSL fusion report midcarpal arthritis in up to 50% of these patients. [1][2][3][4] This will become symptomatic in some patients and may even require conversion to a total wrist arthrodesis. Likely multifactorial in nature, the etiology of this midcarpal degeneration has not been established. Proposed theories explain the degeneration as a delayed effect of the initial insult or as an effect of altered joint environments resulting from the fusion....

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Capitate-based kinematics of the midcarpal joint during wrist radioulnar deviation: an in vivo three-dimensional motion analysis

Cited by 86 publications

References 27 publications

The Dart-Throwing Motion of the Wrist: Is It Unique to Humans?

The Dart-Throwing Motion of the Wrist: Is It Unique to Humans?

3D kinematic analysis of the acromioclavicular joint during arm abduction using vertically open MRI

Simulated Radioscapholunate Fusion Alters Carpal Kinematics While Preserving Dart-Thrower's Motion

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