Subject-Specific Carpal Ligament Elongation in Extreme Positions, Grip, and the Dart Thrower's Motion

Rainbow, Michael J.; Kamal, Robin N.; Moore, Douglas C.; Akelman, Edward; Wolfe, Scott W.; Crisco, Joseph J.

doi:10.1115/1.4031580

Cited by 18 publications

(12 citation statements)

References 37 publications

(71 reference statements)

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“…Ligaments were defined by finding origin and insertion sites that minimized the change in length of the ligament across the measured range of motion. In vivo evidence for the validity of isometric ligaments was recently supplied by Rainbow and colleagues, who found that selected capsular ligaments elongate minimally relative to their maximum length as the wrist moved through a large range of motion (Rainbow et al, 2015).…”

Section: Future Directions and Conclusionmentioning

confidence: 99%

Functional kinematics of the wrist

Rainbow

Wolff

Crisco

et al. 2015

J Hand Surg Eur Vol

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The purpose of this article is to review past and present concepts concerning functional kinematics of the healthy and injured wrist. To provide a context for students of the wrist, we describe the progression of techniques for measuring carpal kinematics over the past century and discuss how this has influenced today's understanding of functional kinematics. Next, we provide an overview of recent developments and highlight the clinical relevance of these findings. We use these findings and recent evidence that supports the importance of coupled motion in early rehabilitation of radiocarpal injuries to develop the argument that coupled motion during functional activities is a clinically relevant outcome; therefore, clinicians should develop a framework for its dynamic assessment. This should enable a tailored and individualized approach to the treatment of carpal injuries.

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Section: Future Directions and Conclusionmentioning

confidence: 99%

Functional kinematics of the wrist

Rainbow

Wolff

Crisco

et al. 2015

J Hand Surg Eur Vol

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“…Although the SCCT has not been widely adopted as an accepted explanation of carpal mechanics, this concept was the basis of the ANAFAB reconstruction and the impetus to create a repair construct by combining selected components of existing repairs. An important reason for the SCCT not being widely accepted is that it fails to accord with the works of others (Kamal et al., 2016; Rainbow et al., 2016). Given that a reliable repair option for scapholunate instability has been elusive (Garcia-Elias, 2013; Sammer and Shin, 2012), an alternative approach, such as the one based on the SCCT, may be a potential new solution.…”

Section: Discussionmentioning

confidence: 99%

“…The stable central column of the carpus requires the motion of the lunate to be controlled and to resist its natural tendency to rotate into extension (Rainbow et al., 2015). As the lunate does not have any direct tendon connections, this stability can be achieved by an anterior tether pulling proximally and, in particular, the long radiolunate ligament (Sandow et al., 2014), acting with a presumed posterior tether pulling distally.…”

Section: Discussionmentioning

confidence: 99%

Anatomical anterior and posterior reconstruction for scapholunate dissociation: preliminary outcome in ten patients

Sandow

Fisher

2019

J Hand Surg Eur Vol

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This study reviews the efficacy of a reconstruction to address scapholunate dissociation using an anterior and posterior approach with a hybrid synthetic tape/tendon weave between the trapezium, scaphoid, lunate and radius: an anatomical front and back (ANAFAB) repair. This repair is a compilation of the components of a number of previously reported repair techniques, and based on published kinematic evidence. It aims to restore the anatomical mechanical constraints on both anterior and posterior aspects of the carpus. Patients were immobilized in a cast for 6 weeks, but no stabilizing wires were used. Ten patients have undergone the reconstruction and were assessed at a minimum 24-month follow-up. They achieved excellent realignment of the carpus, a postoperative median scapholunate gap of 3 mm and a recovery of more than 75% of grip strength and range of motion. No patient required secondary surgery or treatment related to the carpal stabilization. Level of evidence: IV

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“…This study has integrated data from four NIH‐funded computed tomography (CT)‐image based in vivo studies on the wrist and thumb kinematics . The database used in this study has been also made freely available through SimTk.org (https://simtk.org/projects/carpal-database).…”

Section: Methodsmentioning

confidence: 99%

“…Previously, our group published a database of in vivo carpal kinematics and anatomy for 60 healthy wrists . We postulate that expanding the database with additional studies would provide a more complete picture of carpal kinematics. In this study, our first aim was to assemble and describe an expanded open‐source database of in vivo wrist motions from 120 previously studied wrists.…”

mentioning

confidence: 99%

Predicting Carpal Bone Kinematics Using an Expanded Digital Database of Wrist Carpal Bone Anatomy and Kinematics

Akhbari

Moore

Laidlaw

et al. 2019

Journal Orthopaedic Research

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The wrist can be considered a 2 degrees-of-freedom joint with all movements reflecting the combination of flexion-extension and radial-ulnar deviation. Wrist motions are accomplished by the kinematic reduction of the 42 degrees-of-freedom of the individual carpal bones. While previous studies have demonstrated the minimal motion of the scaphoid and lunate as the wrist moves along the dart-thrower's path or small relative motion between hamate-capitate-trapezoid, an understanding of the kinematics of the complete carpus across all wrist motions remains lacking. To address this, we assembled an open-source database of in vivo carpal motions and developed mathematical models of the carpal kinematics as a function of wrist motion. Quadratic surfaces were trained for each of the 42carpal bone degrees-of-freedom and the goodness of fits were evaluated. Using the models, paths of wrist motion that generated minimal carpal rotations or translations were determined. Model predictions were best for flexion-extension, radial-ulnar deviation, and volar-dorsal translations for all carpal bones with R 2 > 0.8, while the estimates were least effective for supination-pronation with R 2 < 0.6. The wrist path of motion's analysis indicated that the distal row of carpal bones moves rigidly together (<3°motion), along the anatomical axis of wrist motion, while the bones in the proximal row undergo minimal motion when the wrist moves in a path oblique to the main axes. The open-source dataset along with its graphical user interface and mathematical models should facilitate clinical visualization and enable new studies of carpal kinematics and function.

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Subject-Specific Carpal Ligament Elongation in Extreme Positions, Grip, and the Dart Thrower's Motion

Cited by 18 publications

References 37 publications

Functional kinematics of the wrist

Functional kinematics of the wrist

Anatomical anterior and posterior reconstruction for scapholunate dissociation: preliminary outcome in ten patients

Predicting Carpal Bone Kinematics Using an Expanded Digital Database of Wrist Carpal Bone Anatomy and Kinematics

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