ROENTGENOLOGIC CONSIDERATION ON THE WRIST INSTABILITY AND A DESIGN OF SUPPORT FOR MOTION STUDY OF THE WRIST

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  • HORIBE TAIKI
    Department of Radiology, Nagoya University Hospital Branch
  • HORIBE HIROE
    Department of Radiology, Nagoya University Hospital Branch
  • NAKAMURA RYOGO
    Department of Orthopedic Surgery, Branch Hospital, Nagoya University School of Medicine

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Other Title
  • 手根骨不安定症におけるX線学的考察と撮影支持装置の考案
  • シュコン ホネ フアンテイショウ ニ オケル Xセンガクテキ コウサツ ト サ

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The diagnosis of the instability of the carpal bones (carpal instability) remained difficult problem. Recently, roentgenographic and anatomical investigations performed by Linscheid et al. and Taleinsnick made advance in the diagnosis. We have also interested in this problem for several years and in this article, describe the outline of carpal instability, method of roentgraphic diagnosis, and the support of motion study designed by us. Necessary projections for the diagnosis are as follows and called motion study of the wrist. Anteroposterior views with the wrist neutral Posteroanterior views with the wrist in radial flexion, neutral, and ulnar flexion. Lateral views with the wrist in dorsiflexion, neutral, and volar flexion. Additional anterior projection making fist may be useful. In the posteroanterior and anteroposterior views, the space between carpal bones are significant to diagnosis and in the lateral views, the relationships of the carpal bones to each other and radius are important to investigate the motion study. On these projections, the positioning of the wrist becomes unstable without any supports. To reduce this difficulty, we designed the suppor for the motion study. This suppor is composed of projection table, forearm support, rail and adaptors for posteroanterior and lateral projections. Absorption rates are increased 34% on anteroposterior projection and 27% on lateral projection by using this support. Magnification rates lies between 1.087 and 1.010. We examined 21 normal wrists and 23 deformed wrists including scapho-lunate dissociation, scaphoid-trapezium-trapezoid dissociation, central carpal instability, non-union of the scaphoid, proximal carpal instability and Kienbock disease. Reviewed results suggested the usefulness of this support.

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