Abstract
To evaluate force transmission patterns in vivo of patients with complaints of wrist instability requiring a proximal row carpectomy, bone mineral density (BMD) patterns of the wrist were established using computed tomography absorptiometry. Normal wrists show a BMD pattern in which the scaphoid fossa and lunate fossa of the distal radius contain a center of force transmission. Wrists with pathology of the proximal carpal row or distal radius show a shift of BMD towards the dorsal edge and the styloid process of the scaphoid fossa. After a proximal row carpectomy, the BMD of the scaphoid fossa decreases, and a BMD center is formed in the center of the lunate fossa, demonstrating that the force transmission is concentrated in its center.
Similar content being viewed by others
References
An KN (1993) The effect of force transmission on the carpus after procedures to treat Kienböck’s disease. Hand Clin 9:445
Aro HT, Wippermann BW, Hodgson SF, Wahner HW, Lewallen DG, Chao EY (1989) Prediction of properties of fracture callus by measurement of mineral density using micro-bone densitometry. J Bone Jt Surg 71A:1020
Blevens AD, Light TR, Jablonsky WS, Smith DG, Patwardhan AG, Guay ME, Woo TS (1989) Radiocarpal articular contact characteristics with scaphoid instability. J Hand Surg 14A:781
Coe MR, Trumble TE (1993) Biomechanical comparison of methods used to treat Kienbock’s disease. Hand Clin 9:417
Garcia-Elias M, Smith DK, Ruby LK, Horii E, An KN, Linscheid RL et al (1994) Normal and abnormal carpal kinematics. In: Schuind F, An KN, Cooney WP, Garcia-Elias M (eds) Advances in the biomechanics of the hand and wrist. Plenum, New York, p 247
Giunta RE, Krimmer H, Krapohl B, Treutlein G, Lanz U, Muller-Gerbl M (1999) Patterns of subchondral bone mineralization in the wrist after midcarpal fusion. J Hand Surg 24A:138
Giunta RE, Lower N, Kierse R, Wilhelm K, Müller-Gerbl MS (1997) Stress on the radiocarpal joint. CT studies of subchondral bone density in vivo. Handchir Mikrochir Plast Chir 29:32
Hara T, Horii E, An KN, Cooney WP, Linscheid RL, Chao EY (1992) Force distribution across wrist joint: application of pressure-sensitive conductive rubber. J Hand Surg 17A:339
Hoogbergen MM, Niessen WJ, Schuurman AH, Spauwen PHM, Kauer JMG (2002) Subchondral bone mineral density patterns representing the loading history of the wrist joint. J Hand Surg 27B:150
Horii E, Garcia-Elias M, Bishop AT, Cooney WP, Linscheid RL, Chao EY (1990) Effect on force transmission across the carpus in procedures used to treat Kienbock’s disease. J Hand Surg 15A:393
Imbriglia JE, Broudy AS, Hagber WC, McKernan D (1990) Proximal row carpectomy: clinical evaluation. J Hand Surg 15A:426
Jeffries AO, Craigen MA, Stanley JK (1994) Wear patterns of the articular cartilage and triangular fibrocartilaginous complex of the wrist: a cadaveric study. J Hand Surg 19B:306
Kazuki K, Kusunoki M, Shimazu A (1991) Pressure distribution in the radiocarpal joint measured with a densitometer designed for pressure-sensitive film. J Hand Surg 16A:401
Kern HP, Jacob AC, Sennwald GR (1994) Force transmission through the proximal carpal row. In: Schuind FA, An KN, Cooney WP, Garcia-Elias M (eds) Advances in the biomechanics of the hand and wrist. Plenum, New York, p 167
Koebke J, Fehrmann P, Mockenhaupt J (1989) Zur Beanspruchung des normalen und des pathologischen Handgelenks Handchir. Mikrochir Plast Chir 21:127
Koebke J, Mockenhaupt J, Lorbach A (1994) Die Subtionsäquidensitometrie als Methode zur Analyse der Gelenkbeanspruchung - Dargstellt am Beispiel des Radiokarpalgelenks. In: Werner E, Matthias AA (eds) Osteologie Interdisziplinär. Springer, Berlin
Kummer B (1985) Einführung in die Biomechanik des Hüftgelenks. Springer, Berlin, Heidelberg
Linscheid RL (1986) Kinematic considerations of the wrist. Clin Orthop 202:27
Maquet P (1984) Biomechanics of the knee, 2nd edn. Springer, Berlin
Masear VR, Zook EG, Pichora DR (1992) Strain-gauge evaluation of lunate unloading procedures. J Hand Surg 17A:437–442
Mayfield JK (1984) Wrist ligamentous anatomy and pathogenesis of carpal instability. Orthop Clin North Am 15:209–216
Müller-Gerbl M (1998) The subchondral bone plate. Adv Anat Embryol Cell Biol 141:III–134
Müller-Gerbl M, Löwer N, Wilhelm K, Kenn R, Putz R (1994) Stress analysis of the radiocarpal joint from a determination of the subchondral mineralisation pattern. In: Schuind FA, An KN, Cooney WP, Garcia-Elias M (eds) Advances in the biomechanics of the hand and wrist. Plenum, New York, pp 159–165
Müller-Gerbl M, Putz R, Kenn R (1993) Verteilungsmuster der Subchondralen Mineralisierung in de Cavitas Glenoidalis bei Normalpersonen, Sportlern und Patienten. Z Orthop Ihre Grenzgeb 131:10–13
Pauwels F (1976) Biomechanics of the normal and diseased hip. Springer, Berlin
Robb RA, Hanson DP (1996) The ANALYZE software system for visualisation and analysis in surgery simulation. In: Taylor RH, Lavallee S, Burdea GC, Mosges R (eds) Computer-integrated surgery. MIT Press, Cambridge, MA, pp 175–189
Short WH, Werner FW, Fortino MD, Palmer AK (1992) Distribution of pressures and forces on the wrist after simulated intercarpal fusion and Kienbock’s disease. J Hand Surg 17A:443–449
Trumble TE, Glisson RR, Seaber AV, Urbaniak JR (1987) Forearm force transmission after surgical treatment of distal radioulnar joint disorders. J Hand Surg 12A:196–202
Trumble TE, Bour CJ, Smith RJ, Glisson RR (1990) Kinematics of the ulnar carpus related to the volar intercalated segment instability pattern. J Hand Surg 15A:384–392
Trumble TE, Glisson RR, Seaber AV, Urbaniak JR (1986) A biomechanical comparison of the methods for treating Kienbock’s disease. J Hand Surg 11A:88–93
Viegas SF, Patterson RM (1994) Contact pressures within wrist joints. In: Schuind FA, An KN, Cooney WP, Garcia-Elias M (eds) Advances in the biomechanics of the hand and wrist. Plenum, New York, p 137
Viegas SF, Patterson RM, Hillman GR, Peterson PD, Crossley M, Foster R (1991) Simulated scaphoid proximal pole fracture. J Hand Surg 16A:495
Viegas SF, Patterson RM, Peterson PD, Pogue DJ, Jenkins DK, Sweo TD et al (1990) Evaluation of the biomechanical efficacy of limited intercarpal fusions for the treatment of scapho-lunate dissociation. J Hand Surg 15A:120
Viegas SF, Tencer AF, Cantrell J, Chang M, Clegg P, Hicks C et al (1987) Load transfer characteristics of the wrist. Part I. The normal joint. J Hand Surg 12A:971
Viegas SF, Tencer AF, Cantrell J, Chang M, Clegg P, Hicks C et al (1987) Load transfer characteristics of the wrist. Part II. Perilunate instability. J Hand Surg 12A:978
Watson HK, Ryu J (1986) Evolution of arthritis of the wrist. Clin Orthop 202:57
Werner FW, Palmer AK, Fortino MD, Short WH (1992) Force transmission through the distal ulna: effect of ulnar variance, lunate fossa angulation, and radial and palmar tilt of the distal radius. J Hand Surg 17A:423
Yin Y, Mann FA, Gilula LA (1996) Positions and techniques. In: Gilula LA, Yin Y (eds) Imaging of the hand and wrist. 1st edn. Saunders, Philadelphia, p 93
Zuiderveld KJ (1995) Visualisation of multimodality medical volume data using object orientated methods. Thesis. University of Utrecht, The Netherlands
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Schots, J.M.P., Niessen, W.J., Schuurman, A.H. et al. Subchondral bone mineral density patterns representing the loading history of the wrist joint after a proximal row carpectomy. Eur J Plast Surg 31, 101–107 (2008). https://doi.org/10.1007/s00238-008-0230-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00238-008-0230-6