High-resolution ultrasonography of the carpal tunnel.
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Twenty-eight wrists of 25 patients with carpal tunnel syndrome (CTS) and 28 wrists of 14 normal control subjects were studied with high-frequency real-time ultrasonography. Three general findings could be observed in CTS, regardless of its cause: swelling of the median nerve at the entrance of the carpal tunnel; flattening of the median nerve in the distal carpal tunnel; and increased palmar flexion of the transverse carpal ligament. Quantitative analysis proved these findings to be significant. We conclude that high-resolution sonography is able to diagnose median nerve compression in the carpal tunnel syndrome and to detect some of its potential causes. (+info)
Scaphoid malunion.
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We reviewed 10 patients with symptomatic malunion of a carpal scaphoid fracture. All had displacement with dorsiflexed intercalated segment instability, and suffered from pain, restricted range of movement at the wrist and decreased grip strength. The restriction of flexion-extension and the decreased grip strength correlated with the severity of the DISI deformity. Seven patients had a corrective osteotomy, using an anterior wedge-shape bone graft with internal fixation by Herbert screw, and all had satisfactory results. We believe that symptoms associated with scaphoid malunion are related to consequent carpal deformity. (+info)
Development of a kinematic 3D carpal model to analyze in vivo soft-tissue interaction across multiple static postures.
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The advantage of throwing the first stone: how understanding the evolutionary demands of Homo sapiens is helping us understand carpal motion.
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Unlike any other diarthrodial joint in the human body, the "wrist joint" is composed of numerous articulations between eight carpal bones, the distal radius, the distal ulna, and five metacarpal bones. The carpal bones articulate with each other as well as with the distal radius, distal ulna, and the metacarpal bases. Multiple theories explaining intercarpal motion have been proposed; however, controversy exists concerning the degree and direction of motion of the individual carpal bones within the two carpal rows during different planes of motion. Recent investigations have suggested that traditional explanations of carpal bone motion may not entirely account for carpal motion in all planes. Better understanding of the complexities of carpal motion through the use of advanced imaging techniques and simultaneous appreciation of human anatomic and functional evolution have led to the hypothesis that the "dart thrower's motion" of the wrist is uniquely human. Carpal kinematic research and current developments in both orthopaedic surgery and anthropology underscore the importance of the dart thrower's motion in human functional activities and the clinical implications of these concepts for orthopaedic surgery and rehabilitation. (+info)
Conformational changes in the carpus during finger trap distraction.
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