Title:Anatomical Wrist Patterns on Plain Radiographs
Volume: 15
Issue: 2
Author(s): Aviv Kramer, Raviv Allon, Alon Wolf, Tal Kalimian, Idit Lavi and Ronit Wollstein*
Affiliation:
- Carmel Lady Davis Medical Center, Department of Plastic Surgery, Haifa,Israel
Keywords:
Midcarpal joint, morphology, patterns, radiographs, wrist, radiographs.
Abstract: Background: Interpreting the structure in the wrist is complicated by the existence of
multiple joints as well as variability in bone shapes and anatomical patterns. Previous studies have
evaluated lunate and capitate shape in an attempt to understand functional anatomical patterns.
Objective: The purpose of this study was to describe anatomical shapes and wrist patterns in normal
wrist radiographs. We hypothesized that there is a significant relationship in the midcarpal joint with
at least one consistent pattern of wrist anatomy.
Methods: Seventy plain posteroanterior (PA) and lateral wrist radiographs were evaluated. These
radiographs were part of a previously established normal database, had all been read by a radiologist
as normal, and had undergone further examination by 2 hand surgeons for quality. Evaluation included:
lunate and capitate shape (type 1 and 2 lunate shape according to the classification system
by Viegas et al.), ulnar variance, radial inclination and height, and volar tilt.
Results: A significant association was found between lunate and capitate shape using a dichotomal
classification system for both lunate and capitate shapes (p=0.003). Type 1 wrists were defined as
lunate type1and a spherical distal capitate. Type 2 wrists had a lunate type 2 and a flat distal capitate.
No statistically significant associations were detected between these wrist types and measurements
of the radiocarpal joint.
Conclusion: There was a significant relationship between the bone shapes within the midcarpal
joint. These were not related to radiocarpal anatomical shape. Further study is necessary to better
describe the two types of wrist patterns that were defined and to understand their influence on wrist
biomechanics and pathology.
