Original articles
Wrist
Carpal bone size and scaling in men versus in women

https://doi.org/10.1016/j.jhsa.2004.08.012Get rights and content

Purpose

The purpose of this study was to quantify carpal bone size, to determine whether gender influences carpal size, and to determine whether small and large carpal bones differ in size only by simple isometric scaling.

Methods

Cortical surfaces of all carpal bones in both wrists of 14 women and 14 men (ages 22–34 y) were reconstructed from computed tomography (CT) volume images. Carpal volume and bounding-box dimensions in 3 orthogonal directions were calculated and compared across genders. An average set of carpal bones were then scaled mathematically by a single factor in all directions (scaled isometrically) and compared across carpal bones of all sizes.

Results

Although female carpal bones were significantly smaller than male carpal bones, individual carpal volume as a percentage of the volume of the entire carpus did not differ with gender. The 3 orthogonal bounding-box dimensions of the carpal bones scaled nearly isometrically from the smallest to the largest bones.

Conclusions

Across the wide range of wrist sizes studied the individual carpal volumes were a consistent percentage of carpus volume and this percentage did not differ with gender. Despite their complex shape the bounding dimensions of the carpal bones increased isometrically with increasing volume. The extensive database of dimensions provided in this study should be useful in the design and insertion of fixation systems and implants.

Section snippets

Subjects and image acquisition

With approval from our Institutional Review Board and after obtaining informed consent, 28 volunteers were recruited for study. Potential volunteers were eligible for inclusion if they were between the ages of 18 and 30 years and had no history of wrist injury or chronic disease that might affect the soft tissues in the wrist. Subjects specifically were excluded if they had a history of wrist or forearm fracture, prior wrist surgery, or severe osteoarthritis or connective tissue disease. At

Results

Our first analysis revealed that the rank order of each carpal volume was the same in the men and women and that on average the carpal bones in the men were larger than those in the women (Fig. 3A, Table 1). For both genders the capitate was the largest bone, followed by the hamate, scaphoid, trapezium, lunate, triquetrum, trapezoid, and pisiform. On average the volumes of the carpal bones in the women were 38% smaller than the corresponding carpal volumes in the men; the difference was largest

Discussion

This study was performed as a first step in determining whether the gender-related differences in carpal size are caused by scaling or whether they represent more complex changes in carpal shape. Our data suggest that the differences primarily are caused by simple scaling. Although we did find gender-related differences in carpal volume for each of the 8 carpal bones, those differences vanished when we compared the normalized volumes of the bones (ie, the relative amount of the carpus that each

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Supported by a National Institutes of Health grant (AR44005).

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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