Assessment of the Piso-Triquetral Kinematics-A Pilot Study Using Dynamic CT
Journal Title: Journal of Orthopaedic Science and Research - Year 2020, Vol 1, Issue 1
Abstract
Introduction: The purpose of this study was to use 4D-CT to quantify the motion of the pisiform with relation to the triquetrum, in order to understand the piso-triquetral joint kinematics through active wrist movements. The use of 4D-CT allowed us to explore kinematic concepts objectively in a quantitative real-time manner, and has the advantage of visualisation in 6 degrees of freedom. Materials and Methods: A normal wrist as was imaged through FE and RUD. Surface rendered models were created from individual carpal bones in each wrist position through the motion arc. These bones were tracked during RUD and FE using a registration algorithm. Radio-ulnar and flexion-extension motions of the pisiform and triquetrum, as well as the piso-triquetral distance were graphed against the global wrist motion. Results: In wrist extension, the pisiform and triquetrum undergo more in-plane motion than the movement of the wrist, and are closest together. During flexion, the bones are furthest away from each other and exhibit out-of-plane (radioulnar deviation) motion in opposite directions. There is minimal out-of-plane motion during extension and during radioulnar deviation. During radioulnar deviation, the minimum articular distance between the pisiform and triquetrum changes negligibly. Conclusions: These in vivo findings, although in a single patient, may be used for further characterisation of dynamic wrist pathology.
Authors and Affiliations
Josipa Petric*, Roland Deek, Neil Kruger, Melanie Amarasooriya, John White, Gregory I Bain
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