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Research Papers

Application of a Three-Dimensional Computational Wrist Model to Proximal Row Carpectomy

[+] Author and Article Information
Jennifer S. Wayne

Fellow ASME
Orthopaedic Research Laboratory,
Departments of Biomedical Engineering and
Orthopaedic Surgery,
Virginia Commonwealth University,
P.O. Box 843067,
Richmond, VA 23284-3067
e-mail: jwayne@vcu.edu

Afsarul Q. Mir

Orthopaedic Research Laboratory,
Departments of Biomedical Engineering and
Orthopaedic Surgery,
Virginia Commonwealth University,
P.O. Box 843067,
Richmond, VA 23284-3067
e-mail: miraq@vcu.edu

1Corresponding author.

Manuscript received August 13, 2014; final manuscript received January 13, 2015; published online March 18, 2015. Assoc. Editor: Zong-Ming Li.

J Biomech Eng 137(6), 061001 (Jun 01, 2015) (7 pages) Paper No: BIO-14-1392; doi: 10.1115/1.4029902 History: Received August 13, 2014; Revised January 13, 2015; Online March 18, 2015

A three-dimensional (3D) computational model of the wrist examined the biomechanical effects of the proximal row carpectomy (PRC), a surgical treatment of certain wrist degenerative conditions but with functional consequences. Model simulations, replicating the 3D bony anatomy, soft tissue restraints, muscle loading, and applied perturbations, demonstrated quantitatively accurate responses for the decreased motions subsequent to the surgical procedure. It also yielded some knowledge of alterations in radiocarpal contact force which likely increase contact pressure as well as additional insight into the importance of the triangular fibrocartilage complex and retinacular/capsular structures for stabilizing the deficient wrist. As better understanding of the wrist joint is achieved, this model could serve as a useful clinical tool.

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Figures

Grahic Jump Location
Fig. 1

Palmar (left) and dorsal (right) aspect of model illustrating the TFCC as a two part structure and the force vectors (interbody arrows) as their connection

Grahic Jump Location
Fig. 2

Distal FR/capsule on the palmar aspect (left) incorporated as tension only structures (vectors). Flexor (right/top) and extensor (right/bottom) retinacular/capsular structures incorporated as rigid bodies connected with tension only vectors. Phalanges excluded for clarity.

Grahic Jump Location
Fig. 3

Flexion and extension wrist motions in the intact normal wrist and after the PRC for the 3D wrist model and the cadaveric study [7]

Grahic Jump Location
Fig. 4

Radial and ulnar deviation wrist motions in the intact normal wrist and after the PRC for the 3D wrist model and the cadaveric study [7]

Grahic Jump Location
Fig. 5

Total wrist motion arc in the intact normal wrist and after the PRC in flexion/extension (F/E) and radial/ulnar (R/U) deviation for the 3D wrist model and the cadaveric study [7]

Grahic Jump Location
Fig. 6

Force transmission in the intact normal wrist and after the PRC in 45 deg flexion, neutral and 45 deg extension for the 3D wrist model and the cadaveric study [8]. Experimental standard deviations estimated at 25%.

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