Maximum loading of carpal bones during movements: a finite element study

Finite Element Modeling of the Human Wrist: A Review

Background  Understanding wrist biomechanics is important to appreciate and treat the wrist joint. Numerical methods, specifically, finite element method (FEM), have been used to overcome experimental methods' limitations. Due to the complexity of the wrist and difficulty in modeling, there is heterogeneity and lack of consistent methodology in the published studies, challenging our ability to incorporate information gleaned from the various studies. Questions/Purposes  This study summarizes the use of FEM to study the wrist in the last decade. Methods  We included studies published from 2012 to 2022 from databases: EBSCO, Research4Life, ScienceDirect, and Scopus. Twenty-two studies were included. Results  FEM used to study wrist in general, pathology, and treatment include diverse topics and are difficult to compare directly. Most studies evaluate normal wrist mechanics, all modeling the bones, with fewer studies including cartilage and ligamentous structures in the model. The dynamic effect of the tendons on wrist mechanics is rarely accounted for. Conclusion  Due to the complexity of wrist mechanics, the current literature remains incomplete. Considering published strategies and modeling techniques may aid in the development of more comprehensive and improved wrist model fidelity.

Lunate loads following different osteotomies used to treat Kienböck's disease: A 3D finite element analysis

BACKGROUND

One of most accepted principles for treating Kienböck's disease before wrist degeneration settles in is to decompress the lunate by an osteotomy. Several osteotomies have been proposed since 1935. However, they are based on biomechanical hypotheses that are sometimes conflicting: This study compares the decompression effect of radius transverse shortening, radius lateral closing and medial closing wedge osteotomies, capitate shortening - with and without hamate shortening - and a Camembert-type radius wedge osteotomy with and without ulnar head shortening according to Sennwald.

METHODS

We built a 3D wrist model using finite elements that included the metacarpal, carpal and forearm bones. All wrist ligaments and Triangular Fibrocartilage Complex were incorporated in the simulation. Load was applied on the metacarpals with the forearm bones fixed. We then applied the different osteotomies to the model.

FINDINGS

When load was applied to the wrist, the osteotomies that best unloaded the lunate were the capitate shortening osteotomy combined with hamate shortening and the Camembert osteotomy combined with ulna shortening; the latter was the only osteotomy that completely unloaded the lunate.

INTERPRETATION

We think the association of the radius Camembert osteotomy and ulna Sennwald's shortening osteotomy is the most effective procedure to propose in Kienböck's disease.

The biomechanical importance of the scaphoid-centrale fusion during simulated knuckle-walking and its implications for human locomotor evolution

Inferring the locomotor behaviour of the last common ancestor (LCA) of humans and African apes is still a divisive issue. An African great-ape-like ancestor using knuckle-walking is still the most parsimonious hypothesis for the LCA, despite diverse conflicting lines of evidence. Crucial to this hypothesis is the role of the centrale in the hominoid wrist, since the fusion of this bone with the scaphoid is among the clearest morphological synapomorphies of African apes and hominins. However, the exact functional significance of this fusion remains unclear. We address this question by carrying out finite element simulations of the hominoid wrist during knuckle-walking by virtually generating fused and unfused morphologies in a sample of hominoids. Finite element analysis was applied to test the hypothesis that a fused scaphoid-centrale better withstands the loads derived from knuckle-walking. The results show that fused morphologies display lower stress values, hence supporting a biomechanical explanation for the fusion as a functional adaptation for knuckle-walking. This functional interpretation for the fusion contrasts with the current inferred positional behaviour of the earliest hominins, thus suggesting that this morphology was probably retained from an LCA that exhibited knuckle-walking as part of its locomotor repertoire and that was probably later exapted for other functions.