Purpose
To quantify the relative motion between the lunate and triquetrum during functional
wrist movements and to examine the impact of wrist laxity on triquetral motion.
Methods
A digital database of wrist bone anatomy and carpal kinematics for 10 healthy volunteers
in 10 different positions was used to study triquetral kinematics. The orientation
of radiotriquetral (RT) and radiolunate rotation axes was compared during a variety
of functional wrist movements, including radioulnar deviation (RUD) and flexion-extension
(FE), and during a hammering task. The motion of the triquetrum relative to the radius
during wrist RUD was compared with passive FE range of motion measurements (used as
a surrogate measure for wrist laxity).
Results
The difference in the orientation of the radiolunate and RT rotation axes was less
than 20° during most of the motions studied, except for radial deviation and for the
first stage of the hammering task. During wrist RUD, the orientation of the RT rotation
axis varied as a function of passive FE wrist range of motion.
Conclusions
The suggestion that the lunate and triquetrum move together as an intercalated segment
may be an oversimplification. We observed synchronous movement during some motions,
but as the wrist entered RUD, the lunate and triquetrum no longer moved synchronously.
These findings challenge the assumptions behind models describing the mechanical function
of the carpals.
Clinical relevance
Individual-specific differences in the amount of relative motion between the triquetrum
and lunate may contribute to the variability in outcomes following lunotriquetral
arthrodesis. Variation in triquetral motion patterns may also have an impact on the
ability of the triquetrum to extend the lunate, affecting the development of carpal
instability.
Key words
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Article info
Publication history
Published online: October 06, 2021
Accepted:
August 20,
2021
Received:
June 29,
2020
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
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© 2022 by the American Society for Surgery of the Hand. All rights reserved.
