University of Alabama Heersink School of Medicine, Birmingham, AL, USA.
Hadassah Medical Center, Jerusalem, Israel.
J Hand Surg Asian Pac Vol. 2024 Aug;29(4):334-342. doi: 10.1142/S2424835524500346. Epub 2024 Jul 12.
Factors such as age and joint structure affect normal wrist motion. The midcarpal joint participates in flexion/extension, radial-ulnar/deviation (RUD), and since lunate/wrist type-2 is likely more stable than a lunate/wrist type-1, we suggest that midcarpal joint structure will affect wrist motion. Our purpose was to compare wrist motion in Caucasian and Japanese populations and to associate motion with midcarpal joint morphology. We hypothesised that radiographic structure would correlate with wrist motion. A total of 164 patients with normal wrist radiographs were included. Clinical measurements included wrist extension, flexion and RUD. Radiographic measurements included the radiocarpal joint: ulnar variance, radial height, radial inclination, volar inclination and carpal joint measurements: lunate type, capitate circumference and each of its joints contact measured and calculated as a proportion of capitate circumference. The groups differed in wrist motion and in multiple radiographic measurements. When the two populations were analysed together, there were no significant associations between midcarpal joint type and wrist motion. The radiocarpal joint: ulnar variance was correlated with extension and radial deviation. Radial height was directly related to flexion, and both radial height and radial inclination were directly correlated with ulnar deviation. The intracarpal measurements: The main measurement affecting motion was the contact between the capitate and the scaphoid (as a proportion of capitate circumference) with lesser correlations of the contact of the capitate with the trapezoid and hamate. The most significant measurement associated with a lunate type-2 was scaphoid contact with the capitate = 0.01. Logistic regression demonstrated that the measurements most associated with wrist motion were scaphoid contact with the capitate/capitate circumference and hamate contact with the capitate/capitate. This study supports discrepancies in wrist motion amongst different racial cohorts, and a relationship between bone/joint structure in the wrist and wrist motion. This can help treat wrist pathology. Level III (Diagnostic).
年龄和关节结构等因素会影响手腕的正常运动。腕中关节参与屈伸、桡偏/尺偏（RUD）运动。由于月骨/腕 2 型比月骨/腕 1 型更稳定，因此我们推测腕中关节结构会影响手腕的运动。我们的目的是比较白人和日本人的手腕运动，并将运动与腕中关节形态联系起来。我们假设影像学结构与手腕运动相关。
共纳入 164 例手腕 X 线正常的患者。临床测量包括手腕伸展、弯曲和 RUD。影像学测量包括腕骨间关节：尺侧偏距、桡骨高度、桡骨倾斜度、掌侧倾斜度和腕骨关节测量：月骨类型、头状骨周长以及每个关节的接触面积，并以头状骨周长的比例进行测量和计算。
两组在手腕运动和多项影像学测量方面存在差异。当将两个人群一起进行分析时，腕中关节类型与手腕运动之间没有显著关联。腕骨间关节：尺侧偏距与伸展和桡侧偏距相关。桡骨高度与弯曲直接相关，桡骨高度和桡骨倾斜度与尺侧偏距直接相关。腕骨间关节：影响运动的主要测量指标是头状骨与舟骨之间的接触（以头状骨周长的比例表示），而头状骨与大、小多角骨之间的接触相关性较小。与月骨 2 型最相关的测量指标是舟骨与头状骨的接触=0.01。逻辑回归显示，与手腕运动最相关的测量指标是舟骨与头状骨的接触/头状骨周长和钩骨与头状骨的接触/头状骨。
本研究支持不同种族人群之间手腕运动存在差异，以及腕骨和关节结构与手腕运动之间存在关系。这有助于治疗手腕病变。
III 级（诊断）。
