Hand and wrist configurations in patients with Carpal Tunnel Syndrome

The association between hand and wrist configurations was investigated in this study. The hand and wrist dimensions of sixty patients with carpal tunnel syndrome and sixty healthy control subjects were measured using specific anatomical landmarks. The palm width was significantly greater in the patient group. There was no significant difference in the hand length between the two groups. Both the wrist width and wrist depth were significantly greater in the patient group. The hand ratio and the wrist ratio were significantly smaller in the patient group indicating that the latter had squarer hands and wrists than the control group respectively. This suggests that the anatomy of the hand and wrist may predispose to carpal tunnel syndrome.peer-reviewe

Different evolutionary pathways underlie the morphology of wrist bones in hominoids

BACKGROUND The hominoid wrist has been a focus of numerous morphological analyses that aim to better understand long-standing questions about the evolution of human and hominoid hand use. However, these same analyses also suggest various scenarios of complex and mosaic patterns of morphological evolution within the wrist and potentially multiple instances of homoplasy that would benefit from require formal analysis within a phylogenetic context.We identify morphological features that principally characterize primate - and, in particular, hominoid (apes, including humans) - wrist evolution and reveal the rate, process and evolutionary timing of patterns of morphological change on individual branches of the primate tree of life. Linear morphological variables of five wrist bones - the scaphoid, lunate, triquetrum, capitate and hamate - are analyzed in a diverse sample of extant hominoids (12 species, 332 specimens), Old World (8 species, 43 specimens) and New World (4 species, 26 specimens) monkeys, fossil Miocene apes (8 species, 20 specimens) and Plio-Pleistocene hominins (8 species, 18 specimens). RESULT Results reveal a combination of parallel and synapomorphic morphology within haplorrhines, and especially within hominoids, across individual wrist bones. Similar morphology of some wrist bones reflects locomotor behaviour shared between clades (scaphoid, triquetrum and capitate) while others (lunate and hamate) indicate clade-specific synapomorphic morphology. Overall, hominoids show increased variation in wrist bone morphology compared with other primate clades, supporting previous analyses, and demonstrate several occurrences of parallel evolution, particularly between orangutans and hylobatids, and among hominines (extant African apes, humans and fossil hominins). CONCLUSIONS Our analyses indicate that different evolutionary processes can underlie the evolution of a single anatomical unit (the wrist) to produce diversity in functional and morphological adaptations across individual wrist bones. These results exemplify a degree of evolutionary and functional independence across different wrist bones, the potential evolvability of skeletal morphology, and help to contextualize the postcranial mosaicism observed in the hominin fossil record

Forward and inverse kinematics of double universal joint robot wrists

A robot wrist consisting of two universal joints can eliminate the wrist singularity problem found on many individual robots. Forward and inverse position and velocity kinematics are presented for such a wrist having three degrees of freedom. Denavit-Hartenberg parameters are derived to find the transforms required for the kinematic equations. The Omni-Wrist, a commercial double universal joint robot wrist, is studied in detail. There are four levels of kinematic parameters identified for this wrist; three forward and three inverse maps are presented for both position and velocity. These equations relate the hand coordinate frame to the wrist base frame. They are sufficient for control of the wrist standing alone. When the wrist is attached to a manipulator arm; the offset between the two universal joints complicates the solution of the overall kinematics problem. All wrist coordinate frame origins are not coincident, which prevents decoupling of position and orientation for manipulator inverse kinematics

Using finite element method in preoperative planning for wrist surgery

The wrist has a wide variation of 'normal' anatomy, which may explain the discrepancy seen in success rates of some clinical procedures between patients with similar symptoms. Previously published finite element models of the wrist joint have been based on a single geometry and/or single loading condition which does not give a full representation of the spectrum of normal wrists. In this study, three finite element models of the wrist were created and used subject specific boundary conditions thus building a set of models which can be identified as a part of a larger population. Systematic variations in anatomy and bone position were studied and the effect they have on the general load transfer through the normal wrist joint. That information can prove to be important for future surgical planning on the wrist joint

Effects of partial wrist arthrodesis on loading at the radiocarpal joints

The radiocarpal joint plays an important role in the stabilization of the wrist joint. Degenerative diseases such as rheumatoid arthritis can destabilize the joint and compromise the kinematics of the carpal bones. Partial wrist arthrodesis in the rheumatoid wrist has been popular since its introduction in 1983 [1]. The procedure prevents ulnar drift of the carpus and prevents progression to a subluxed state as well as providing pain relief for the patient. The biomechanical consequences of arthrodesis at the radiocarpal joint have not been extensively explored. This study looks at the biomechanical changes on the load transfer through the radiocarpal joint after partial wrist fusion

Categorical perception of tactile distance

The tactile surface forms a continuous sheet covering the body. And yet, the perceived distance between two touches varies across stimulation sites. Perceived tactile distance is larger when stimuli cross over the wrist, compared to when both fall on either the hand or the forearm. This effect could reflect a categorical distortion of tactile space across body-part boundaries (in which stimuli crossing the wrist boundary are perceptually elongated) or may simply reflect a localised increased in acuity surrounding anatomical landmarks (in which stimuli near the wrist are perceptually elongated). We tested these two interpretations, by comparing a well-documented bias to perceive mediolateral tactile distances across the forearm/hand as larger than proximodistal ones along the forearm/hand at three different sites (hand, wrist, and forearm). According to the ‘categorical’ interpretation, tactile distances should be elongated selectively in the proximodistal axis thus reducing the anisotropy. According to the ‘localised acuity’ interpretation, distances will be perceptually elongated in the vicinity of the wrist regardless of orientation, leading to increased overall size without affecting anisotropy. Consistent with the categorical account, we found a reduction in the magnitude of anisotropy at the wrist, with no evidence of a corresponding specialized increase in precision. These findings demonstrate that we reference touch to a representation of the body that is categorically segmented into discrete parts, which consequently influences the perception of tactile distance

Ultrasound of the wrist ligaments

Injuries of the intrinsic and extrinsic wrist ligaments can lead to chronic wrist pain and carpal instability, while injuries of the triangular fibrocartilage complex (TFCC) are a frequent cause of ulnar-sided wrist pain. In the recent past, magnetic resonance (MR) arthrography was the preferred imaging modality for the evaluation of these structures, but good results can also achieved with standard MR imaging, computed tomographic (CT) arthrography and more recently ultrasonography (US). Advantages of US of the wrist over MR imaging and MR arthrography include: lower cost, no intraarticular injection of contrast material, no ionizing radiation, no limitations due to MR incompatible implants, and real-time visualisation with possible dynamic evaluation. However US is operator dependent and requires high quality equipment.peer-reviewe

Effect of Imperceptible Vibratory Noise Applied to Wrist Skin On Fingertip Touch Evoked Potentials – An EEG Study

Random vibration applied to skin can change the sense of touch. Specifically, low amplitude white-noise vibration can improve fingertip touch perception. In fact, fingertip touch sensation can improve even when imperceptible random vibration is applied to other remote upper extremity areas such as wrist, dorsum of the hand, or forearm. As such, vibration can be used to manipulate sensory feedback and improve dexterity, particularly during neurological rehabilitation. Nonetheless, the neurological bases for remote vibration enhanced sensory feedback are yet poorly understood. This study examined how imperceptible random vibration applied to the wrist changes cortical activity for fingertip sensation. We measured somatosensory evoked potentials to assess peak-to-peak response to light touch of the index fingertip with applied wrist vibration versus without. We observed increased peak-to-peak somatosensory evoked potentials with wrist vibration, especially with increased amplitude of the later component for the somatosensory, motor, and premotor cortex with wrist vibration. These findings corroborate an enhanced cortical-level sensory response motivated by vibration. It is possible that the cortical modulation observed here is the result of the establishment of transient networks for improved perception

The association between graded physical activity in postmenopausal British women, and the prevalence and incidence of hip and wrist fractures.

BACKGROUND: physical activity is promoted for older women as a means of maintaining health and avoiding falls and fractures. Findings relating physical activity of older women to risk of falls and fracture are contradictory. The association between level of physical activity and prevalent and incident hip and wrist fractures was examined in a large representative sample of postmenopausal British women. METHODS: data from the British Women's Heart and Health Study, a cohort study of 4286 postmenopausal women aged 60-79, from 23 UK towns were used. Information on physical activity, anthropometry, falls and hip and wrist fractures from baseline examination and questionnaire (1999-2001) and follow-up questionnaire (2007) were available. Cross-sectional baseline prevalence data were analysed using logistic regression and cohort incidence data using a Cox proportional hazards model examining the association of physical activity with fracture outcomes. RESULTS: 3003 (70%) women, with complete baseline data, were studied. 13.6% had previously fractured a wrist and 1.3% a hip. Analyses unadjusted for confounders showed moderate protective associations between activity and fracture risk. After adjustment for confounders there was a weak trend towards fewer hip fractures (adjusted OR 0.13 [0.01, 1.18]) and more wrist fractures (adjusted OR 1.35 [0.76, 2.48]), amongst most active compared with inactive women. The crude incidence rate of wrist and/or hip fracture was 7.0 [5.9, 8.2] per 1000 person-years. No evidence was found for an association between physical activity and combined incident hip and/or wrist fracture (adjusted rate ratio inactive versus most active 1.69 [0.67, 4.24]). CONCLUSION: no clear associations between graded physical activity and hip/wrist fractures were seen but estimates were imprecise. Physical activities are heterogeneous and individual fracture types and mechanisms differ. Very large prospective observational studies are required to disentangle the precise effects of different activity patterns on different fracture types