Four-Dimensional CT Assessment of the Transverse Carpal Ligament Attachments-A Pilot Study
Journal Title: Journal of Orthopaedic Science and Research - Year 2020, Vol 1, Issue 1
Abstract
Introduction: The wrist is a complex joint, and static imaging techniques may not capture subtle kinematic abnormalities. Four-dimensional (4D) CT presents an alternative method of assessing the dynamic movement of the Transverse Carpal Ligament (TCL). The TCL is important in carpal stability, grip strength, and as a component of the flexor pulley system. The purpose of this study is to determine the dynamic displacement of the TCL attachment points in-vivo through wrist Flexion-Extension (FE) and Radio-Ulnar (RUD) deviation using 4D CT. 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 using 4D CT scans. These bones were tracked using a registration algorithm, and their translations were graphed against the global wrist motion. Results: During wrist flexion, all TCL attachment points moved proximally and volarly. There was minimal displacement of the attachments in the radioulnar plane. During wrist ulnar to radial deviation, the radial attachment points moved proximally and ulnar attachment points distally. In the radioulnar plane, all attachment points moved radially, except scaphoid, which translated ulnarly. The scapho-pisiform distance showed marked shortening in wrist radial deviation. Conclusions: This study demonstrates that 4D-CT can be effectively utilized to assess TCL kinematics in-vivo. The TCL is a dynamic structure with distinct movements in all three planes, dependent on the wrist’s direction of movement.
Authors and Affiliations
Roland Deek*, Josipa Petric, Neil Kruger, Melanie Amarasooriya, John White, Gregory I Bain
Keywords
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- EP ID EP698810
- DOI http://dx.doi.org/10.46889/JOSR.2020.1105
- Views 74
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