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      Four-dimensional rotational radiographic scanning of the wrist in patients after proximal row carpectomy

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          Abstract

          We measured cartilage thickness, contact surface area, volume of the capitate and shape of the capitate during motion in the operated and unaffected wrists of 11 patients with a mean follow-up of 7.3 years after proximal row carpectomy. Radiocapitate cartilage thickness in the operated wrists did not differ significantly from radiolunate cartilage thickness in the unaffected wrists. The radiolunate surface area was significantly less than the radiocapitate surface area. The volume of the capitate was significantly increased in the operated wrists. The shape of the capitate changed significantly in two of three orthogonal directions. The combination of remodelling of the capitate, increase in its surface area and intact cartilage thickness could help to explain the clinical success of proximal row carpectomy.

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          Proximal row carpectomy: minimum 20-year follow-up.

          Lindley Wall, Michael L DiDonna, Thomas Kiefhaber … (2013)
          Proximal row carpectomy (PRC) is a motion-sparing procedure for degenerative disorders of the proximal carpal row. Reported results at a minimum 10-year follow-up consistently show maintenance of strength, motion, and satisfaction with an average conversion rate to radiocarpal arthrodesis of 12%. We hypothesized that PRC would continue to provide a high level of satisfaction and function at a minimum of 20 years.
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            In-vivo three-dimensional carpal bone kinematics during flexion-extension and radio-ulnar deviation of the wrist: Dynamic motion versus step-wise static wrist positions.

            M Foumani, S.D. Strackee, R Jonges … (2009)
            An in-vivo approach to the measurement of three-dimensional motion patterns of carpal bones in the wrist may have future diagnostic applications, particularly for ligament injuries of the wrist. Static methods to measure carpal kinematics in-vivo only provide an approximation of the true kinematics of the carpal bones. This study is aimed at finding the difference between dynamically and statically acquired carpal kinematics. For eight healthy subjects, static and a dynamic measurements of the carpal kinematics were performed for a flexion-extension and a radio-ulnar deviation movement. Dynamic scans were acquired by using a four-dimensional X-ray imaging system during an imposed cyclic motion. To assess static kinematics of the wrists, three-dimensional rotational X-ray scans were acquired during step-wise flexion-extension and radio-ulnar deviation. The helical axis rotations and the rotation components. i.e. flexion-extension, radio-ulnar deviation and pro-supination were the primary parameters. Linear mixed model statistical analysis was used to determine the significance of the difference between the dynamically and statically acquired rotations of the carpal bones. Small and in most cases negligible differences were observed between the dynamic motion and the step-wise static motion of the carpal bones. The conclusion is that in the case of individuals without any pathology of the wrist, carpal kinematics can be studied either dynamically or statically. Further research is required to investigate the dynamic in-vivo carpal kinematics in patients with dynamic wrist problems.
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              Proximal row carpectomy for advanced Kienböck's disease: average 10-year follow-up.

              S Croog, Chantal E. Stern (2008)
              To evaluate the clinical and radiographic results after a proximal row carpectomy for Lichtman stage III and IV Kienböck's disease at an average 10-year follow-up. Twenty-one patients with either Lichtman stage IIIA, IIIB, or IV Kienböck's disease were treated surgically at an average age of 38 years. At follow-up evaluation, each patient was evaluated subjectively with the Quick Disabilities of the Arm, Shoulder, and Hand and the Patient-Related Wrist Evaluation questionnaires (both are validated, patient-reported questionnaires assessing pain and function) and objectively with an assessment of range of motion and grip strength. Radiographs were obtained to assess the radiocapitate articulation. Three patients had persistent pain after a proximal row carpectomy requiring a radiocapitate arthrodesis at a mean of 23 months (range, 5-53 months). Two of these 3 patients had preoperative stage IV disease. The remaining 18 patients were evaluated at an average follow-up of 10 years (range, 4-17 years). The average wrist flexion-extension arc was 105 degrees, which averaged 78% of that of the contralateral wrist. Average maximal grip strength was 35 kg, which averaged 87% of that of the contralateral wrist. Average Quick Disabilities of the Arm, Shoulder, and Hand score was 12 points and average Patient-Related Wrist Evaluation score was 17 points, each representing minimal functional limitation. Radiographic analysis at final follow-up demonstrated degeneration of the radiocapitate articulation in 16 patients. Narrowing of the joint space was rated as none in 2 wrists, partial in 10 wrists, and complete in 4 wrists. There was no significant association between the radiographic findings and the subjective and objective outcome. At an average follow-up of 10 years, proximal row carpectomy is a reliable and durable procedure for patients with Lichtman stage IIIA or IIIB Kienböck's disease. Caution should be exercised in performing the procedure in patients with stage IV disease because of risk of early symptomatic radiocapitate degeneration. Therapeutic IV.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Hand Surg Eur Vol
                Journal ID (iso-abbrev): J Hand Surg Eur Vol
                Journal ID (publisher-id): JHS
                Journal ID (hwp): spjhs
                Title: The Journal of Hand Surgery, European Volume
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Print): 1753-1934
                ISSN (Electronic): 2043-6289
                Publication date (Electronic): 06 July 2017
                Publication date (Print): October 2017
                Volume: 42
                Issue: 8
                Pages: 846-851
                Affiliations
                [1 ]Department of Plastic, Reconstructive and Hand Surgery, University of Amsterdam, Amsterdam, The Netherlands
                [2 ]Department of Biomedical Engineering and Physics, University of Amsterdam, Amsterdam, The Netherlands
                Author notes
                [*]A. Peymani, Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, Room G4-226, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, The Netherlands. Email: a.peymani@ 123456amc.uva.nl
                Article
                Publisher ID: 10.1177_1753193417718427
                DOI: 10.1177/1753193417718427
                PMC ID: 5598872
                PubMed ID: 28681691
                SO-VID: 7f36fb37-3951-4889-be32-fc6b4d3d3deb
                Copyright © © The Author(s) 2017
                License:

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Date received : 3 February 2017
                Date revision received : 6 June 2017
                Date accepted : 7 June 2017
                Categories
                Subject: Full Length Article

                Keywords: wrist,proximal row carpectomy,biomechanics,dynamic wrist imaging
                Data availability:
                Keywords: wrist, proximal row carpectomy, biomechanics, dynamic wrist imaging

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