Introduction
This work was initiated by Dr Michael Sandow, Orthopaedic Surgeon, with the help of True Life Creations in early 1998 to better demonstrate wrist motion in 3D. Findings to date, such as the relationship between the trapezium and scaphoid bones, and the extent of translation of the lunate have already had clinical consequences in the development and modification of reconstructive techniques.

While the initial work has concentrated on the wrist, the technique of rules based modelling is showing enormous potential to analyse motion abnormalities in other joints such as the temporomandibular, ankle, knee and shoulder.

The work has now expanded to utilise the breakthroughs in Surface (Threshold) Rendering technology to create a suite of imaging software that creates unsurpassed access to true 3D image data. Musculo-sketal imaging has been the prime development focus but now expanding into Vascular surgery, Neurosurgery and ENT.

3D Representation
Previous static three dimensional representation of bones using CT scanning techniques has been very useful to demonstrate static structures such as fractures but has limited usefulness in situations where motion and stability assessment is important. By creating multiple sequetial views, a dynamic appreciation of a range of injuries and disorders can be analysed and treatment plans developed and tested. Patients can at last see, in a way they can understand, what the problem is and what treatment is planned.

True Life Anatomy retains its strong research focus, but has licenced the distribution of the initial suite of 3D imaging software through RuBaMAS - www.rubamas.com

Integration
The integration of 3D object mapping with animation / motion software can simulate the dynamic relationship between particular bones of the body (e.g. the wrist) using a step frame animation technique. This provides the opportunity to visualise a representation of normal motion as has not been possible previously. Further, by using complex motion tracking software, individual bone movement in space can be quantified. This allows the identification of the rules and constraints that control the motion, and in particular the movement characteristics of individual bones as well the spatial relationship between adjacent bones.

These patented motion analysis concepts are being developed into powerful clinical assessment tools, and are currently undergoing validation studies to confirm their usefulness in guiding therapeutic strategies.