Skip to main content

Advertisement

SpringerLink
Log in

Postero-anterior radiography of the wrist normal database of carpal measurements

Radiographie de face du poignet -Base de données normale des mesures carpiennes

  • Radiologic Anatomy
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Summary

This study aims to establish a normal database of carpal postero-anterior radiographic measurements that might be a useful alternative to lateral film measurements in clinical practice. Selected landmarks were digitised on 80 postero-anterior wrist radiographs of asymptomatic volunteers. Carpal bone dimensions, ulnar variance, carpal height ratios, radial slope and various carpal angles were computed. Moreover, we describe two new parameters, the scapho-lunate ratios, that may prove useful in the diagnosis of carpal instability. Average values for carpal height, length of metacarpal III, capitate length, ulnar variance, radial slope and classical and revised carpal height ratios agreed with previous findings. Scaphoid length averaged 22 ± 3 mm, lunate anterior and posterior horn lengths 11 ± 1 mm and 16 ± 2 mm respectively. Except for carpal height and length of metacarpal III, standard deviations did not exceed 3 mm. Some of the variation coefficients reached 30% of the average dimension, so that variations, compared to means were not negligible. The standard deviations of angular measurements ranged from 3° to 13°. Further investigations are needed to confirm the usefulness of scapho-lunate ratios.

Résumé

Cette étude présente une base de données normales des mesures radiographiques postéro-antérieures du poignet qui pourrait être une alternative utile aux mesures sur cliché en incidence latérale en pratique clinique. Des repères choisis ont été numérisés sur 80 radiographies en incidence postéro-antérieure du poignet de volontaires asymptomatiques. Les dimensions carpiennes, la variance ulnaire, les rapports de hauteur carpienne, la pente radiale et plusieurs angles carpiens ont été calculés. En outre, nous décrivons deux nouveaux paramètres, les rapports scapho-lunaires, qui pourraient s'avérer utiles dans le diagnostic de l'instabilité carpienne. Les valeurs moyennes de la hauteur carpienne, de la longueur du troisième métacarpien, de la longueur du capitatum, de la variance ulnaire, de la pente radiale et des rapports de hauteur carpienne étaient en accord avec les observations antérieures. La longueur du scaphoïde valait en moyenne 22 ± 3 mm, les longueurs des cornes ventrale et dorsale du lunatum 11 ± 1 mm et 16 ± 2 mm respectivement. Hormis la hauteur carpienne et la longueur du troisième métacarpien, les écarts-type n'excédaient pas 3 mm. Certains des coefficients de variation atteignaient 30% de la dimension moyenne, de sorte que les variations, par rapport aux moyennes, n'étaient pas négligeables. Les mensurations angulaires présentaient un écarttype compris entre 3 et 13°. Des investigations complémentaires sont nécessaires pour confirmer l'utilité des rapports scapho-lunaires.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Altissimi M, Antenucci R, Fiacca C, Mancini GB (1986) Long-term results of conservative treatment of fractures of the distal radius. Clin Orthop 206: 202–210

    Google Scholar 

  2. Bade H (1991) Pathomorphologie des Handgelenks bei Fehlstellungen des distalen Radius nach knöchern verheilter Fraktur. Handchir Mikrochir Plast Chir 23: 3–10

    Google Scholar 

  3. Beckenbaugh RD, Shives TC, Dobyns JH, Linscheid RL (1980) Kienböck's disease: the natural history of Kienböck's disease and consideration of lunate fractures. Clin Orthop 149: 98–106

    Google Scholar 

  4. Belsole RJ, Hilbelink DR, Llewellyn JA, Dale M, Ogden JA (1991) Carpal orientation from computed reference axes. J Hand Surg 16A: 82–90

    Google Scholar 

  5. Bonjean P, Honton JL, Linarte R, Vignes J (1981) Anatomical bases for the dynamic exploration of the wrist joint. Anat Clin 3: 73–85

    Google Scholar 

  6. Bonnel F, Allieu Y (1984) Les articulations radio-cubito-carpienne et médio-carpienne. Organisation anatomique et bases biomécaniques. Ann Chir Main 3: 287–296

    Google Scholar 

  7. Burgess RC (1990) Anatomical variations of the midcarpal joint. J Hand Surg [Am] 15: 129–131

    Google Scholar 

  8. Cantor RM, Braunstein EM (1988) Diagnosis of dorsal and palmar rotation of the lunate on a frontal radiograph. J Hand Surg [Am] 13: 187–193

    Google Scholar 

  9. Castaing J (1964) Les fractures récentes de l'extrémité inférieure du radius chez l'adulte. Rev Chir Orthop 50: 581–595

    Google Scholar 

  10. Chen WS, Shih CH (1990) Ulnar variance and Kienböck's disease: an investigation in Taiwan. Clin Orthop 255: 124–127

    Google Scholar 

  11. Craighen MAC, Stanley JK (1995) Wrist kinematics: row, column or both? J Hand Surg [Br] 20: 165–170

    Google Scholar 

  12. Czitrom AA, Dobyns JH, Linscheid RL (1987) Ulnar variance in carpal instability. J Hand Surg [Am] 12: 205–208

    Google Scholar 

  13. de Lange A, Huiskes R, Kauer JMG (1990) Wrist-joint ligament length changes in flexion and deviation of the hand: an experimental study. J Orthop Res 8: 722–730

    Google Scholar 

  14. De Smet L, De Vriese L, D'Hoore K, Fabri G (1994) No relation between ulnar variance and scapholunate dissociation. Acta Orthop Scand 65: 623–624

    Google Scholar 

  15. Efremov S, Oberlin C (1996) The pisiformtriquetral complex: an anatomical study. J Hand Surg Br 21 [Suppl 1]: 20

    Google Scholar 

  16. Feipel V, Rooze M (1997) Morphology of the capsular wrist ligaments. Eur J Morphol 35: 787–94

    Google Scholar 

  17. Friberg S, Lundström B (1976) Radiographic measurements of the radio-carpal joint in normal adults. Acta Radiol Diagn 17: 359–256

    Google Scholar 

  18. Fumière E, Feipel V (1994) Radio-anatomie du poignet. Radiologie 14: 44–54

    Google Scholar 

  19. Garcia-Elias M, An KN, Amadio PC, Cooney WP, Linscheid RL (1989) Reliability of carpal angle determinations. J Hand Surg [Am] 14: 1017–1021

    Google Scholar 

  20. Hogikyan JV, Louis DS (1992) Embryologic development and variations in the anatomy of the ulnocarpal ligamentous complex. J Hand Surg [Am] 17: 719–723

    Google Scholar 

  21. Jupiter JB (1991) Current concepts review: fractures of the distal end of the radius. J Bone Joint Surg [Am] 73: 461–469

    Google Scholar 

  22. Kapandji IA (1987) Biomécanique du carpe et du poignet. Ann Chir Main 6: 147–169

    Google Scholar 

  23. Kristensen SS, Thomassen E, Christensen F (1986) Ulnar variance determination. J Bone Joint Surg [Br] 11L-B: 255–257

    Google Scholar 

  24. Larsen CF, Stigsby B, Mathiesen FK, Lindequist S (1990) Radiography of the wrist: a new device for standardized radiographs. Acta Radiol 31: 459–462

    Google Scholar 

  25. Larsen CF, Mathiesen FK, Lindequist S (1991) Measurements of carpal bone angles on lateral wrist radiographs. J Hand Surg [Am] 16: 888–893

    Google Scholar 

  26. Levinsohn EM (1990) Imaging of the wrist. Radiol Clin North Am 28: 905–921

    Google Scholar 

  27. Lewis OJ, Hamshere RJ, Bucknill TM (1970) The anatomy of the wrist joint. J Anat 106: 539–552

    Google Scholar 

  28. Linscheid RL (1986) Kinematic considerations of the wrist. Clin Orthop 202: 27–39

    Google Scholar 

  29. Mann FA, Wilson AJ, Gilula LA (1992) Radiographic evaluation of the wrist: what does the hand surgeon want to know? Radiology 184: 15–24

    Google Scholar 

  30. Mizuseki T, Ikuta Y (1989) The dorsal carpal ligaments: their anatomy and function. J Hand Surg [Br] 14: 91–98

    Google Scholar 

  31. Nakamura R, Tanaka Y, Imaeda T, Miura T (1991) The influence of age and sex on ulnar variance. J Hand Surg [Br] 16: 84–88

    Google Scholar 

  32. Nattrass GR, King JW, McMurtry RY, Brant RF (1994) An alternative method for determination of the carpal height ratio. J Bone Joint Surg [Am] 76 L-A: 88–94

    Google Scholar 

  33. Nonnenmacher J, Naett R, Ben Abid M (1978) Instabilité du carpe après cal vicieux du poignet chez l'adulte. Ann Chir 32: 561–564

    Google Scholar 

  34. Ogden JA, Beall JK, Conlogue GJ, Light TR (1981) Radiology of postnatal skeletal development. Skeletal Radiol 6: 255–266

    Google Scholar 

  35. Ranawat CS, DeFiore J, Straub LR (1975) Madelung's deformity: an end-result study of surgical treatment. J Bone Joint Surg [Am] 57: 772–775

    Google Scholar 

  36. Salvia P, Klein P, David JH, Rooze M (1994) The envelope of active wrist circumduction: an in vivo electrogonimetric study. In: Schuind F, et al. (eds) Advances in the biomechanics of the hand and wrist. NATO ASI Series (vol. A 256). Plenum Press, New York, pp 313–329

    Google Scholar 

  37. Savelberg HHCM, Kooloos JGM, Huiskes R, Kauer JMG (1992) Strains and forces in selected carpal ligament during in vitro flexion and deviation of the hand. J Orthop Res 10: 901–910

    Google Scholar 

  38. Schernberg F (1990) Roentgenographic examination of the wrist: a systematic study of the normal, lax and injured wrist. (Part 1): The standard and positional views. J Hand Surg L [Br] 15: 210–219

    Google Scholar 

  39. Schmidt HM, Geissler F (1983) Die Artikulationsflächen des proximalen Handgelenks beim Menschen. Z Morphol Anthrop 74: 145–172

    Google Scholar 

  40. Schuind FA, Linscheid RL, An KN, Chao EYS (1992) A normal database of posteroanterior roentgenographic measurements of the wrist. J Bone Joint Surg L [Am] 17: 1418–1429

    Google Scholar 

  41. Schuind F, Alemzadeh S, Stallenberg B, Burny F (1996) Does the normal contralateral wrist provide the best reference for X-ray film measurements of the pathological wrist? J Hand Surg 21A: 24–30

    Google Scholar 

  42. Smith DK (1993) Dorsal carpal ligaments of the wrist: normal appearance on multiplanar reconstructions of three-dimensional Fourier transform MR imaging. Am J Roentgenol 161: 119–125

    Google Scholar 

  43. Stahelin A, Pfeiffer K Sennwald G, Segmüller G (1989) Determining carpal collapse. An improved method. J Bone Joint Surg [Am] 71: 1400–1405

    Google Scholar 

  44. Steyers CM, Blair WF (1989) Measuring ulnar variance: a comparison of techniques. J Hand Surg [Am] 14: 607–612

    Google Scholar 

  45. Taleisnik J (1976) The ligaments of the wrist. J Hand Surg 1: 110–118

    Google Scholar 

  46. Tanaka Y (1989) Study of ulnar variance. J Japan Soc Surg Hand 6: 120–130

    Google Scholar 

  47. Tsuge S, Nakamura R (1993). Anatomical risk factors for Kienböck's disease. J Hand Surg [Br] 18: 70–75

    Google Scholar 

  48. Viegas SF, Patterson RM, Hokanson JA, Davis J (1993) Wrist anatomy: incidence, distribution, and correlation of anatomical variations, tears, and arthrosis. J Hand Surg [Am] 18: 463–475

    Google Scholar 

  49. Von Lanz T, Wachsmuth W (1959) Praktische Anatomie, 2nd edn. Springer, Berlin

    Google Scholar 

  50. Voorhees DR, Daffner RH, Nunley JA, Gilula LA (1985) Carpal ligamentous disruptions and negative ulnar variance. Skeletal Radiol 13: 257–262

    Google Scholar 

  51. Youm Y, McMurtry RY, Flatt AE, Gillespie TE (1978) Kinematics of the wrist. I. An experimental study of radio-ulnar deviation and flexion-extension. J Bone Joint Surg [Am] 60: 423–431

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Laboratory for Functional Anatomy, University of Brussels, 808, route de Lennik, CP 619, B-1070, Brussels, Belgium

    V. Feipel, D. Rinnen & M. Rooze

Authors
  1. V. Feipel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. D. Rinnen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Rooze
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Feipel, V., Rinnen, D. & Rooze, M. Postero-anterior radiography of the wrist normal database of carpal measurements. Surg Radiol Anat 20, 221–226 (1998). https://doi.org/10.1007/BF01628899

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01628899

Key words

Search

Navigation