Wolfe S W, Neu C, Crisco J J
Yale Hand and Upper Extremity Center, Department of Orthopaedic and Rehabilitation, Yale University School of Medicine, New Haven, CT 06820-8071, USA.
J Hand Surg Am. 2000 Sep;25(5):860-9. doi: 10.1053/jhsu.2000.9423.
Carpal kinematics have been previously limited to in vitro models with cadaveric specimens. Using a newly developed markerless bone registration algorithm, we noninvasively studied the in vivo kinematics of the capitate, scaphoid, and lunate during wrist extension and flexion in both wrists of 5 men and 5 women. Computed tomography volume images were acquired in neutral and in 2 positions in both extension and flexion. The 3-dimensional kinematics of the capitate, scaphoid, and lunate relative to the radius were the determined. Scaphoid and lunate rotations differed for flexion and extension but were found to vary linearly with capitate rotation. In flexion the scaphoid contributed 73% of capitate motion and the lunate contributed 46%. In extension the scaphoid contributed 99% of capitate motion and the lunate contributed 68%. Contributions of the scaphoid and lunate to wrist extension were 15% greater than values reported in previous in vitro studies, while scaphoid and lunate contributions to wrist flexion were more similar to previous studies. The findings support a relative "engagement" of the scaphoid, capitate, and lunate during wrist extension. The only difference between male and female kinematics was a more distal location of the rotation axes; we believe this was due to a difference in carpal bone size, not gender. This study reports the 3-dimensional in vivo measurement of carpal motion using a noninvasive technology. This technique may prove useful in the study of more complex motions of the hand and wrist and of the abnormal kinematics that occur following ligamentous injury.
腕关节运动学研究此前仅限于使用尸体标本的体外模型。利用一种新开发的无标记骨配准算法，我们对5名男性和5名女性双腕在腕关节伸展和屈曲过程中头状骨、舟骨和月骨的体内运动学进行了无创研究。在中立位以及伸展和屈曲的两个位置采集计算机断层扫描容积图像。确定了头状骨、舟骨和月骨相对于桡骨的三维运动学。舟骨和月骨在屈曲和伸展时的旋转不同，但发现它们随头状骨旋转呈线性变化。在屈曲时，舟骨对头状骨运动的贡献为73%，月骨为46%。在伸展时，舟骨对头状骨运动的贡献为99%，月骨为68%。舟骨和月骨对腕关节伸展的贡献比先前体外研究报告的值大15%，而舟骨和月骨对腕关节屈曲的贡献与先前研究更相似。这些发现支持了腕关节伸展过程中舟骨、头状骨和月骨的相对“啮合”。男性和女性运动学的唯一差异是旋转轴位置更靠远侧；我们认为这是由于腕骨大小的差异，而非性别差异。本研究报告了使用无创技术对腕骨运动进行的三维体内测量。该技术可能在研究手部和腕部更复杂的运动以及韧带损伤后出现的异常运动学方面证明有用。
