The understanding of the joints of the wrist; their anatomy, biomechanics and pathology has long been a topic for few dedicated
researchers. A field that has never been top priority for decision makers; it is rarely if ever life threatening. And yet, in
light of an ever increasing, healthy and active, ageing population, degenerative arthritis is quickly becoming one of the main
challenges to the medical field.
Specifically, a significant portion of disability due to osteoarthritis (OA) is attributable to the hand and wrist. A very recent
study in Pennsylvania, found that the overall lifetime risk of symptomatic hand OA was 39.8% and 47.2% of women had an
estimated lifetime risk of developing symptomatic hand OA by age 85 years [1]. Recent advances in the study of the structure
and function of the wrist are therefore important first steps on our path to optimization of the treatment of wrist arthritis.
We would like to dedicate this issue to one of the founders of this field- of the study of the wrist-Professor Louis A. Gilula
who passed away in 2014.
Professor Gilula was a giant in musculoskeletal medicine, overarching and connecting the fields of Radiology, Orthopedic
Surgery and Plastic and Reconstructive Surgery. A kind and dedicated teacher and researcher, his contributions to our field
have been invaluable and all encompassing. We believe he would enjoy this issue.
This issue attempts to encompass the recent advances in our understanding of the wrist and its specific joints from the perspective
of how anatomical structure affects function. Anatomically, the wrist is defined as comprising all joints from (and including)
the distal radioulnar joint (DRUJ) proximally, to the carpometacarpal joints distally. Evaluation of structure of wrist
cartilage is described by Sivak et al. [2]. Sandow describes a biomechanical model to understand wrist joint function [3]. Dr.
Nakamura’s article reviews the recent trends in anatomy and function of the DRUJ [4]. Moving more distally the anatomy and
function of the midcarpal and scaphotrapezialtrapezoid joint are discussed in the studies by Kramer et al., Rhee et al., Iida et al.
[4, 5, 9]. Wei et al. discuss procedures to treat arthritis and their effect on biomechanics of the joint [6], while Luria discusses
fractures [7]. Werner et al. discuss the mechanics through the wrist during performance of push-ups [8].
The Scaphoid motion of the wrist with scapho-trapezio-trapezoidal osteoarthritis and the Capitate and Lunate Morphology
in Normal Wrist Radiographs-A Pilot Study has been discussed by Wollstein et al. [9, 10].
Due to the complexity of the joint, we are still in preliminary stages of investigation and this issue is a summary of our
combined preliminary efforts.
