CARPAL MOTION DURING MOBILIZATION

Therapists treating hand and wrist problems frequently perform mobilizations of the radiocarpal and intercarpal joints. The purpose of this investigation was to use prosection, digital photography (2D & 3D), and radiographic techniques to quantify carpal movement during wrist flexion and extension. Methods The soft tissue of the antebrachium was dissected sufficiently to allow placement of marker wires into the dorsal surfaces of the carpals, radius, and 3 rd metacarpal. The tendons for the wrist motors were freed and used to flex, extend, radially and ulnarly deviate the wrist. The topography of the joint surfaces of the capitohamate and triquetrohamate joints were examined stereoscopically. Results Absolute and relative motion of the carpals, as identified using radiographic analysis, is presented in Table 1. Total wrist motion was 61° for flexion and 33° for extension. The hamate demonstrated the greatest absolute and relative motion during flexion; whereas the capitate demonstrated the greatest motion in extension. Examination of the joint surfaces of the isolated carpals suggested that the motions of flexion and extension at the "midcarpal" joint occur around an axis that passes through the scaphoid, capitate, hamate and triquetrum, with the scaphoid and the medial portion of the triquetrum convex distally and the capitate and hamate convex proximally.