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Research Papers

Movement of the Distal Carpal Row During Narrowing and Widening of the Carpal Arch Width

[+] Author and Article Information
Joseph N. Gabra

Departments of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195; Department of Chemical and Biomedical Engineering,  Cleveland State University, Cleveland, OH 44115

Mathieu Domalain

Departments of Biomedical Engineering, Cleveland Clinic, Cleveland, OH 44195

Zong-Ming Li1

Departments of Biomedical Engineering, Orthopaedic Surgery, and Physical Medicine and Rehabilitation, Cleveland Clinic, Cleveland, OH 44195; Department of Chemical and Biomedical Engineering,  Cleveland State University, Cleveland, OH 44115liz4@ccf.org

1

Corresponding author.

J Biomech Eng 134(10), 101004 (Oct 01, 2012) (4 pages) doi:10.1115/1.4007634 History: Received May 01, 2012; Revised August 30, 2012; Posted September 25, 2012; Published October 01, 2012

Change in carpal arch width (CAW) is associated with wrist movement, carpal tunnel release, or therapeutic tunnel manipulation. This study investigated the angular rotations of the distal carpal joints as the CAW was adjusted. The CAW was narrowed and widened by 2 and 4 mm in seven cadaveric specimens while the bone positions were tracked by a marker-based motion capture system. The joints mainly pronated during CAW narrowing and supinated during widening. Ranges of motion about the pronation axis for the hamate-capitate (H-C), capitate-trapezoid (C-Td), and trapezoid-trapezium (Td-Tm) joints were 8.1 ± 2.3 deg, 5.3 ± 1.3 deg, and 5.5 ± 3.5 deg, respectively. Differences between the angular rotations of the joints were found at ΔCAW = −4 mm about the pronation and ulnar-deviation axes. For the pronation axis, angular rotations of the H-C joint were larger than that of the C-Td and Td-Tm joints. Statistical interactions among the factors of joint, rotation axis, and ΔCAW indicated complex joint motion patterns. The complex three-dimensional motion of the bones can be attributed to several anatomical constraints such as bone arrangement, ligament attachments, and articular congruence. The results of this study provide insight into the mechanisms of carpal tunnel adaptations in response to biomechanical alterations of the structural components.

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Copyright © 2012 by American Society of Mechanical Engineers
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Figures

Grahic Jump Location
Figure 1

Experimental setup showing the (a) fingertrap, (b) pulleys, and (c) turnbuckle for widening of the carpal arch width (volar view)

Grahic Jump Location
Figure 2

Dorsal view of the specimen during experimentation showing the marker clusters and radial coordinate system

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Figure 3

Mean rotation angles (deg) about the pronation/supination (Y), flexion/extension (Z ′), and ulnar/radial deviation (X ″) axes for each joint during changes in carpal arch width (mm). Pronation, flexion, and ulnar deviation are the positive directions for the respective axes.

Grahic Jump Location
Figure 4

Mean ± standard deviation of angular rotation for each joint at ΔCAW = −4 and +4 mm for the pronation/supination (Y), flexion/extension (Z ′), and ulnar/radial deviation (X″) axes. (* denotes p < 0.001 and # denotes p < 0.05). Pronation, flexion, and ulnar deviation are the positive directions for the respective axes.

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