The Carpal Height Ratio for The Trinidadian Population: What is Normal?

Aim: To determine the normal carpal height ratio for the Trinidadian population. Design & method: A retrospective review of wrist radiographs performed during the period January 2022 to June 2022 at San Fernando General Hospital was conducted. A total of 200 radiographs were independently reviewed by two blinded assessors utilizing the PACS system. The carpal height ratio (CHR) and revised carpal height (RCH) ratio was calculated using two methods. A p-value Results: The radiographs reviewed consisted of 94 female and 106 male patients with an age range of 19 to 86 years. The mean CHR was 0.473 and the revised CHR 1.469. The ratio for carpal height as well as the revised CHR was observed to vary amongst the different age groups studied. The CHR and revised CHR for the population was observed to vary based on gender with gender significantly influencing the CHR value (p = 0.001). Conclusions: The CHR of the Trinidadian population as calculated by the data collected falls below the average CHR documented worldwide. However, the interpretation of this value is based on the baseline reference ratio for a population. Therefore, according to our average CHR for our population previous comparison of a CHR index to international figures would have led to erroneous interpretation of results. A decrease in CHR is indicative of carpal collapse. The comparison of CHR to the established normal CHR for the population is believed to allow for early detection of carpal collapse.

Computerized geometric features of carpal bone for bone age estimation

Background Bone age development is one of the significant indicators depicting the growth status of children. However, bone age assessment is an heuristic and tedious work for pediatricians. We developed a computerized bone age estimation system based on the analysis of geometric features of carpal bones. Methods The geometric features of carpals were extracted and analyzed to judge the bone age of children by computerized shape and area description. Four classifiers, linear, nearest neighbor, back-propagation neural network, and radial basis function neural network, were adopted to categorize bone age. Principal component and discriminate analyses were employed to improve assorting accuracy. Results The hand X-ray films of 465 boys and 444 girls served as our database. The features were extracted from carpal bone images, including shape, area, and sequence. The proposed normalization area ratio method was effective in bone age classification by simulation. Besides, features statistics showed similar results between the standard of the Greulich and Pyle atlas and our database. Conclusions The bone area has a higher discriminating power to judge bone age. The ossification sequence of trapezium and trapezoid bones between Taiwan Residents and the atlas of the GP method is quite different. These results also indicate that carpal bone assessment with classification of neural networks can be correct and practical.

Unusual combined fracture dislocation of the wrist and metacarpophalangeal joints： a case report and review of the literature

Volar perilunate fracture dislocation is an extremely rare carpal injury, but associated with metacarpophalangeal joint dislocation of both the ipsilateral index and middle finger has never been reported. We report one case of a 28-year-old man following a high-energy trauma. After performing closed reduction of the metacarpophalangeal joint injury, open reduction of the wrist injury through volar approach was done, and a K-wire fixation was used to stabilize the scaphoid fracture and lunotriquetral joint. After a 16 months＇ follow-up period, the wrist regained a full range of motion without symptoms, and the fractured bone was strengthened in a good position.