Kinematics of the wrist. I. An experimental study of radial-ulnar deviation and flexion-extension.

The kinematics of the wrist during radial-ulnar deviation and flexion-extension were studied in several ways. In six fresh cadaver wrists, the forearm was fixed in full pronation, each motion was constrained to one plane, and two metal markers were placed in each of the finger metacarpals, as well as in the radius and all of the carpal bones except the pisiform and greater multangular. Radial ulnar and flexion-extension movements in these wrists were studied roentgenographically. In the wrists of six normal volunteers, a similar roentgenographic analysis was carried out and the trajectories of wrist motions also were studied using light-emitting diodes. Finally, roentgenographic measurements were made on 100 wrists of normal subjects. From these studies, it was concluded that: (1) during each of these motions, rotation occurs about a fixed axis located within the head of the capitate, and the location of each axis is not changed by the position of the hand in either plane; (2) the distance from the base of the third metacarpal to the distal articular surface of the radius (the carpal height), measured along the proximally projected axis of the third metacarpal on posteroanterior roentgenograms, is constant throughout radial-ulnar deviation of the normal wrist and can be used as a measure of carpal collapse; and (3) the perpendicular distance of the fixed axis of rotation for radial-ulnar deviation from the distally projected longitudinal axis of the ulna can be used as a quantitative measurement of the amount of translation of the carpus in pathological conditions.