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Glanville J, Bates KT, Brown D, Potts D, Curran J, Fichera S. Evaluation of a cadaveric wrist motion simulator using marker-based X-ray reconstruction of moving morphology. PeerJ 2024; 12:e17179. [PMID: 38803578 PMCID: PMC11129696 DOI: 10.7717/peerj.17179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/05/2024] [Indexed: 05/29/2024] Open
Abstract
Surgical intervention is a common option for the treatment of wrist joint arthritis and traumatic wrist injury. Whether this surgery is arthrodesis or a motion preserving procedure such as arthroplasty, wrist joint biomechanics are inevitably altered. To evaluate effects of surgery on parameters such as range of motion, efficiency and carpal kinematics, repeatable and controlled motion of cadaveric specimens is required. This study describes the development of a device that enables cadaveric wrist motion to be simulated before and after motion preserving surgery in a highly controlled manner. The simulator achieves joint motion through the application of predetermined displacements to the five major tendons of the wrist, and records tendon forces. A pilot experiment using six wrists aimed to evaluate its accuracy and reproducibility. Biplanar X-ray videoradiography (BPVR) and X-Ray Reconstruction of Moving Morphology (XROMM) were used to measure overall wrist angles before and after total wrist arthroplasty. The simulator was able to produce flexion, extension, radioulnar deviation, dart thrower's motion and circumduction within previously reported functional ranges of motion. Pre- and post-surgical wrist angles did not significantly differ. Intra-specimen motion trials were repeatable; root mean square errors between individual trials and average wrist angle and tendon force profiles were below 1° and 2 N respectively. Inter-specimen variation was higher, likely due to anatomical variation and lack of wrist position feedback. In conclusion, combining repeatable intra-specimen cadaveric motion simulation with BPVR and XROMM can be used to determine potential effects of motion preserving surgeries on wrist range of motion and biomechanics.
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Affiliation(s)
- Joanna Glanville
- School of Engineering, University of Liverpool, Liverpool, Merseyside, United Kingdom
- Department of Musculoskeletal & Ageing Science, University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - Karl T. Bates
- Department of Musculoskeletal & Ageing Science, University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - Daniel Brown
- Liverpool Orthopaedic and Trauma Service, Liverpool University Hospitals, Liverpool, Merseyside, United Kingdom
| | - Daniel Potts
- School of Engineering, University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - John Curran
- School of Engineering, University of Liverpool, Liverpool, Merseyside, United Kingdom
| | - Sebastiano Fichera
- School of Engineering, University of Liverpool, Liverpool, Merseyside, United Kingdom
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2
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Yang Y, Wang Y, Zheng N, Cheng R, Zou D, Zhao J, Tsai TY. Development and Validation of a Novel In Vitro Joint Testing System for Reproduction of In Vivo Dynamic Muscle Force. Bioengineering (Basel) 2023; 10:1006. [PMID: 37760108 PMCID: PMC10525521 DOI: 10.3390/bioengineering10091006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/28/2023] [Accepted: 08/15/2023] [Indexed: 09/29/2023] Open
Abstract
In vitro biomechanical experiments utilizing cadaveric specimens are one of the most effective methods for rehearsing surgical procedures, testing implants, and guiding postoperative rehabilitation. Applying dynamic physiological muscle force to the specimens is a challenge to reconstructing the environment of bionic mechanics in vivo, which is often ignored in the in vitro experiment. The current work aims to establish a hardware platform and numerical computation methods to reproduce dynamic muscle forces that can be applied to mechanical testing on in vitro specimens. Dynamic muscle loading is simulated through numerical computation, and the inputs of the platform will be derived. Then, the accuracy and robustness of the platform will be evaluated through actual muscle loading tests in vitro. The tests were run on three muscles (gastrocnemius lateralis, the rectus femoris, and the semitendinosus) around the knee joint and the results showed that the platform can accurately reproduce the magnitude of muscle strength (errors range from -6.2% to 1.81%) and changing pattern (goodness-of-fit range coefficient ranges from 0.00 to 0.06) of target muscle forces. The robustness of the platform is mainly manifested in that the platform can still accurately reproduce muscle force after changing the hardware combination. Additionally, the standard deviation of repeated test results is very small (standard ranges of hardware combination 1: 0.34 N~2.79 N vs. hardware combination 2: 0.68 N~2.93 N). Thus, the platform can stably and accurately reproduce muscle forces in vitro, and it has great potential to be applied in the future musculoskeletal loading system.
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Affiliation(s)
- Yangyang Yang
- School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200230, China; (Y.Y.); (Y.W.); (N.Z.); (R.C.); (D.Z.)
- Department of Orthopedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- Engineering Research Center for Digital Medicine, Ministry of Education, Shanghai 200230, China
| | - Yufan Wang
- School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200230, China; (Y.Y.); (Y.W.); (N.Z.); (R.C.); (D.Z.)
- Department of Orthopedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- Engineering Research Center for Digital Medicine, Ministry of Education, Shanghai 200230, China
| | - Nan Zheng
- School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200230, China; (Y.Y.); (Y.W.); (N.Z.); (R.C.); (D.Z.)
- Department of Orthopedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- Engineering Research Center for Digital Medicine, Ministry of Education, Shanghai 200230, China
| | - Rongshan Cheng
- School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200230, China; (Y.Y.); (Y.W.); (N.Z.); (R.C.); (D.Z.)
- Department of Orthopedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- Engineering Research Center for Digital Medicine, Ministry of Education, Shanghai 200230, China
| | - Diyang Zou
- School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200230, China; (Y.Y.); (Y.W.); (N.Z.); (R.C.); (D.Z.)
- Department of Orthopedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- Engineering Research Center for Digital Medicine, Ministry of Education, Shanghai 200230, China
| | - Jie Zhao
- School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200230, China; (Y.Y.); (Y.W.); (N.Z.); (R.C.); (D.Z.)
- Department of Orthopedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- Engineering Research Center for Digital Medicine, Ministry of Education, Shanghai 200230, China
- Shanghai Key Laboratory of Orthopaedic Implants & Clinical Translation R&D Center of 3D Printing Technology, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Tsung-Yuan Tsai
- School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200230, China; (Y.Y.); (Y.W.); (N.Z.); (R.C.); (D.Z.)
- Department of Orthopedics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
- Engineering Research Center for Digital Medicine, Ministry of Education, Shanghai 200230, China
- Shanghai Key Laboratory of Orthopaedic Implants & Clinical Translation R&D Center of 3D Printing Technology, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
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Hwang JS, Li Q, Kim J. A quantitative measurement of trapeziometacarpal joint pressure using a cadaveric model of lateral pinch. J Orthop Res 2022; 40:1523-1528. [PMID: 34664302 DOI: 10.1002/jor.25188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/13/2021] [Accepted: 09/30/2021] [Indexed: 02/04/2023]
Abstract
Trapeziectomy is performed for trapeziometacarpal (TMC) arthritis but decreased lateral pinch strength is a major source of discomfort after the surgery. The magnitude of the decrease is unclear, however, and how the pressure changes in the TMC joint is unknown. To investigate this relationship, we designed a cadaveric study to measure TMC joint pressure using a lateral pinch model, and quantitatively evaluated the effect of trapeziectomy on the pressure measurements. For 10 cadaveric forearms, physiologic forces were applied across the thumb TMC joint by loading five tendons, thereby simulating lateral pinch. Using pressure sensors, we measured the lateral pinch pressure and TMC joint pressure, which averaged 10.1 (range, 4.2-16.2) kg/cm2 and 2.0 (range, 0.8-4.4) kg/cm2 , respectively. A significant correlation between the measurements was found, with an average ratio of 19% (range, 10%-27%). After trapeziectomy and interposition of the tendon ball using flexor carpi radialis, the pressure measurements were repeated under the same conditions. Significant changes were found, which averaged 5.1 (range, 1.7-10.7) kg/cm2 for lateral pinch pressure and 15.0 (range, 5.6-25.6) kg/cm2 for TMC joint pressure. In conclusion, TMC joint pressure could be measured as the ratio relative to lateral pinch pressure using a cadaveric model. After trapeziectomy, the lateral pinch strength decreased, whereas the TMC joint pressure increased.
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Affiliation(s)
- Ji Sup Hwang
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Qingyuan Li
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Hand and Microsurgery, Tianjin Hospital, Tianjin, China
| | - Jihyeung Kim
- Department of Orthopedic Surgery, Seoul National University Hospital, Seoul, Republic of Korea
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Razavian RS, Dreyfuss D, Katakura M, Horwitz MD, Kedgley AE. An in vitro hand simulator for simultaneous control of hand and wrist movements. IEEE Trans Biomed Eng 2021; 69:975-982. [PMID: 34495828 DOI: 10.1109/tbme.2021.3110893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A human hand is a complex biomechanical system, in which bones, ligaments, and musculotendon units dynamically interact to produce seemingly simple motions. A new physiological hand simulator has been developed, in which electromechanical actuators apply load to the tendons of extrinsic hand and wrist muscles to recreate movements in cadaveric specimens in a biofidelic way. This novel simulator simultaneously and independently controls the movements of the wrist (flexion/extension and radio-ulnar deviation) and flexion/extension of the fingers and thumb. Control of these four degrees of freedom (DOF) is made possible by actuating eleven extrinsic muscles of the hand. The coupled dynamics of the wrist, fingers, and thumb, and the over-actuated nature of the human musculoskeletal system make feedback control of hand movements challenging. Two control algorithms were developed and tested. The optimal controller relies on an optimization algorithm to calculate the required tendon tensions using the collective error in all DOFs, and the action-based controller loads the tendons solely based on their actions on the controlled DOFs (e.g., activating all flexors if a flexing moment is required). Both controllers resulted in hand movements with small errors from the reference trajectories (<3.4); however, the optimal controller achieved this with 16% lower total force. Owing to its simpler structure, the action-based controller was extended to enable feedback control of grip force. This simulator has been shown to be a highly repeatable tool (<0.25 N and <0.2 variations in force and kinematics, respectively) for in vitro analyses of human hand biomechanics.
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Fan YL, Xu HY, Xia MY, Zhang W, Wen HL, Gao LB, Pei YH. Biomechanical evaluation of axial-loading simulated experiment in wrist fractures: a finite element analysis. J Int Med Res 2020; 48:300060520966884. [PMID: 33135534 PMCID: PMC7780565 DOI: 10.1177/0300060520966884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective To assess the biomechanical properties that influence wrist fracture, so as to provide the theoretical basis for simulation experiments to aid the optimal design of wrist protectors. Methods Six cadaveric wrists were included as experimental specimens. Wrist specimens wearing wrist protectors formed the experimental group and unprotected wrist specimens formed the control group. The wrist specimens were axially loaded under physiological loads and the stress magnitude and distribution of the experimental and control groups were obtained. A three-dimensional wrist finite element model of a healthy volunteer was developed to verify the rationality and effectiveness of the cadaveric wrist models. Results Under normal physiological loads, the stress on the radioulnar palmar unit was high and manifested in the form of pressure, while the stress on the radioulnar dorsal unit was lower and manifested in the form of tension. The stresses on the radial distal palmar, ulnar distal palmar, radial distal dorsal, ulnar distal dorsal, radial proximal palmar and ulnar proximal palmar units in the experimental group were less than those in the control group. Conclusion Under physiological loads, wearing a wrist protector can reduce the stress on the radioulnar distal palmar, radioulnar proximal palmar and radioulnar distal dorsal units, while having no obvious effect on the radioulnar proximal dorsal units.
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Affiliation(s)
- You-Liang Fan
- Department of Orthopaedics, Changzhou Fourth People's Hospital (Changzhou Cancer Hospital Affiliated to Soochow University), Changzhou, Jiangsu Province, China
| | - Hai-Yun Xu
- Department of Orthopaedics, Changzhou Fourth People's Hospital (Changzhou Cancer Hospital Affiliated to Soochow University), Changzhou, Jiangsu Province, China
| | - Ming-Yang Xia
- Department of Orthopaedics, Changzhou Fourth People's Hospital (Changzhou Cancer Hospital Affiliated to Soochow University), Changzhou, Jiangsu Province, China
| | - Wen Zhang
- Department of Orthopaedics, Orthopaedic Institute, Soochow University, Suzhou, Jiangsu Province, China
| | - Hui-Long Wen
- Department of Orthopaedics, Changzhou Fourth People's Hospital (Changzhou Cancer Hospital Affiliated to Soochow University), Changzhou, Jiangsu Province, China
| | - Li-Bo Gao
- Department of Orthopaedics, Changzhou Fourth People's Hospital (Changzhou Cancer Hospital Affiliated to Soochow University), Changzhou, Jiangsu Province, China
| | - Yan-Hui Pei
- Department of Orthopaedics, Changzhou Fourth People's Hospital (Changzhou Cancer Hospital Affiliated to Soochow University), Changzhou, Jiangsu Province, China
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Camus EJ, Aimar A, Van Overstraeten L, Schuind F, Innocenti B. Lunate loads following different osteotomies used to treat Kienböck's disease: A 3D finite element analysis. Clin Biomech (Bristol, Avon) 2020; 78:105090. [PMID: 32562880 DOI: 10.1016/j.clinbiomech.2020.105090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/08/2020] [Accepted: 06/09/2020] [Indexed: 02/07/2023]
Abstract
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.
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Affiliation(s)
- Emmanuel J Camus
- SELARL Chirurgie de la main et du pied, 94bis rue Gustave Delory, 59810, Lesquin, France; ULB Brussels Free University, Erasme Hospital, Lennik road No 808, Brussels, Belgium.
| | - Anna Aimar
- ULB Brussels Free University-Ecole Polytechnique de Bruxelles, Beams (Bio, Electro And Mechanical Systems) Dept., Avenue Franklin Roosevelt No 50, Brussels, Belgium
| | - Luc Van Overstraeten
- ULB Brussels Free University, Erasme Hospital, Lennik road No 808, Brussels, Belgium; HFSU rue Pierre Caille No 9, 7500 Tournai, Belgium
| | - Frédéric Schuind
- ULB Brussels Free University, Erasme Hospital, Lennik road No 808, Brussels, Belgium
| | - Bernardo Innocenti
- ULB Brussels Free University-Ecole Polytechnique de Bruxelles, Beams (Bio, Electro And Mechanical Systems) Dept., Avenue Franklin Roosevelt No 50, Brussels, Belgium
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Badida R, Garcia-Lopez E, Sise C, Moore DC, Crisco JJ. An Approach to Robotic Testing of the Wrist Using Three-Dimensional Imaging and a Hybrid Testing Methodology. J Biomech Eng 2020; 142:064501. [PMID: 31960897 PMCID: PMC7172869 DOI: 10.1115/1.4046050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 01/03/2020] [Indexed: 11/08/2022]
Abstract
Robotic technology is increasingly used for sophisticated in vitro testing designed to understand the subtleties of joint biomechanics. Typically, the joint coordinate systems in these studies are established via palpation and digitization of anatomic landmarks. We are interested in wrist mechanics in which overlying soft tissues and indistinct bony features can introduce considerable variation in landmark localization, leading to descriptions of kinematics and kinetics that may not appropriately align with the bony anatomy. In the wrist, testing is often performed using either load or displacement control with standard material testers. However, these control modes either do not consider all six degrees-of-freedom (DOF) or reflect the nonlinear mechanical properties of the wrist joint. The development of an appropriate protocol to investigate complexities of wrist mechanics would potentially advance our understanding of normal, pathological, and artificial wrist function. In this study, we report a novel methodology for using CT imaging to generate anatomically aligned coordinate systems and a new methodology for robotic testing of wrist. The methodology is demonstrated with the testing of 9 intact cadaver specimens in 24 unique directions of wrist motion to a resultant torque of 2.0 N·m. The mean orientation of the major principal axis of range of motion (ROM) envelope was oriented 12.1 ± 2.7 deg toward ulnar flexion, which was significantly different (p < 0.001) from the anatomical flexion/extension axis. The largest wrist ROM was 98 ± 9.3 deg in the direction of ulnar flexion, 15 deg ulnar from pure flexion, consistent with previous studies [1,2]. Interestingly, the radial and ulnar components of the resultant torque were the most dominant across all directions of wrist motion. The results of this study showed that we can efficiently register anatomical coordinate systems from CT imaging space to robotic test space adaptable to any cadaveric joint experiments and demonstrated a combined load-position strategy for robotic testing of wrist.
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Affiliation(s)
- Rohit Badida
- Department of Orthopedics, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Brown University, Providence, RI 02903
| | - Edgar Garcia-Lopez
- Department of Orthopedics, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Brown University, Providence, RI 02903
| | - Claire Sise
- Department of Biomedical Engineering, Brown University, Providence, RI 02912
| | - Douglas C. Moore
- Department of Orthopedics, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Brown University, Providence, RI 02903
| | - Joseph J. Crisco
- Department of Biomedical Engineering, Brown University, Providence, RI 02912; Department of Orthopedics, Warren Alpert Medical School of Brown University and Rhode Island Hospital, Brown University, Providence, RI 02903
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8
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Graul I, Lindner R, Schettler N, Friedel R, Hofmann GO. Deviations in positioning variable pitch screws- scaphoid waist fractures. Orthop Traumatol Surg Res 2020; 106:347-351. [PMID: 31899116 DOI: 10.1016/j.otsr.2019.10.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/10/2019] [Accepted: 10/07/2019] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Operative therapy using a headless cannulated variable pitch compression screw is the gold standard for the treatment of instable scaphoid fractures. HYPOTHESIS Deviation from the central placement is associated with a loss of stability and stiffness. MATERIAL AND METHODS An artificial bone model was manufactured and different screw positions (central, 10° and 20° to the long axis) were assessed. A shearing test with axial force on the 45° flexed scaphoid was applied. RESULTS The inserted variable pitch screw showed the highest stiffness and failure force in a position in the long axis. At 10 degrees, a slight decrease in stiffness (32.7N/mm±9.3N/mm) and failure force (41.6N±13.2N) was observed, while a significant reduction in stiffness (29.3N/mm±4.6N/mm) and failure force (50.3N±19.5N) was measured at 20 degrees. DISCUSSION Deviations in the angle of insertion of the compression screw cause loss in failure force, thus deviations from the central placement is associated with less stability and stiffness. LEVEL OF PROOF Controlled laboratory study (basic science study, biomechanical testing).
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Affiliation(s)
- Isabel Graul
- Department of Trauma-, Hand- and Reconstructive Surgery, University Jena, Germany.
| | - Robert Lindner
- Department of Trauma-, Hand- and Reconstructive Surgery, University Jena, Germany
| | - Nicky Schettler
- Department of Trauma, Orthopedics and hand surgery, Helios Erfurt, Germany
| | - Reinhard Friedel
- Department of Trauma-, Hand- and Reconstructive Surgery, University Jena, Germany
| | - Gunther O Hofmann
- Department of Trauma-, Hand- and Reconstructive Surgery, University Jena, Germany; Department of Trauma, BG Bergmanstrost, Halle, Germany
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9
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Shah DS, Middleton C, Gurdezi S, Horwitz MD, Kedgley AE. The importance of abductor pollicis longus in wrist motions: A physiological wrist simulator study. J Biomech 2018; 77:218-222. [PMID: 30054091 PMCID: PMC6085116 DOI: 10.1016/j.jbiomech.2018.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 07/01/2018] [Accepted: 07/04/2018] [Indexed: 11/29/2022]
Abstract
The abductor pollicis longus (APL) is one of the primary radial deviators of the wrist, owing to its insertion at the base of the first metacarpal and its large moment arm about the radioulnar deviation axis. Although it plays a vital role in surgical reconstructions of the wrist and hand, it is often neglected while simulating wrist motions in vitro. The aim of this study was to observe the effects of the absence of APL on the distribution of muscle forces during wrist motions. A validated physiological wrist simulator was used to replicate cyclic planar and complex wrist motions in cadaveric specimens by applying tensile loads to six wrist muscles - flexor carpi radialis (FCR), flexor carpi ulnaris, extensor carpi radialis longus (ECRL), extensor carpi radialis brevis, extensor carpi ulnaris (ECU) and APL. Resultant muscle forces for active wrist motions with and without actuating the APL were compared. The absence of APL resulted in higher forces in FCR and ECRL - the synergists of APL - and lower forces in ECU - the antagonist of APL. The altered distribution of wrist muscle forces observed in the absence of active APL control could significantly alter the efficacy of in vitro experiments conducted on wrist simulators, in particular when investigating those surgical reconstructions or rehabilitation of the wrist heavily reliant on the APL, such as treatments for basal thumb osteoarthritis.
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Affiliation(s)
- Darshan S Shah
- Department of Bioengineering, Imperial College London, London, United Kingdom.
| | - Claire Middleton
- Department of Hand Surgery, Chelsea and Westminster Hospital, London, United Kingdom.
| | - Sabahat Gurdezi
- Department of Hand Surgery, Chelsea and Westminster Hospital, London, United Kingdom
| | - Maxim D Horwitz
- Department of Hand Surgery, Chelsea and Westminster Hospital, London, United Kingdom.
| | - Angela E Kedgley
- Department of Bioengineering, Imperial College London, London, United Kingdom.
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10
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Shah DS, Middleton C, Gurdezi S, Horwitz MD, Kedgley AE. The effects of wrist motion and hand orientation on muscle forces: A physiologic wrist simulator study. J Biomech 2017; 60:232-237. [PMID: 28669547 PMCID: PMC5555257 DOI: 10.1016/j.jbiomech.2017.06.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 06/02/2017] [Accepted: 06/05/2017] [Indexed: 11/30/2022]
Abstract
Although the orientations of the hand and forearm vary for different wrist rehabilitation protocols, their effect on muscle forces has not been quantified. Physiologic simulators enable a biomechanical evaluation of the joint by recreating functional motions in cadaveric specimens. Control strategies used to actuate joints in physiologic simulators usually employ position or force feedback alone to achieve optimum load distribution across the muscles. After successful tests on a phantom limb, unique combinations of position and force feedback – hybrid control and cascade control – were used to simulate multiple cyclic wrist motions of flexion-extension, radioulnar deviation, dart thrower’s motion, and circumduction using six muscles in ten cadaveric specimens. Low kinematic errors and coefficients of variation of muscle forces were observed for planar and complex wrist motions using both novel control strategies. The effect of gravity was most pronounced when the hand was in the horizontal orientation, resulting in higher extensor forces (p < 0.017) and higher out-of-plane kinematic errors (p < 0.007), as compared to the vertically upward or downward orientations. Muscle forces were also affected by the direction of rotation during circumduction. The peak force of flexor carpi radialis was higher in clockwise circumduction (p = 0.017), while that of flexor carpi ulnaris was higher in anticlockwise circumduction (p = 0.013). Thus, the physiologic wrist simulator accurately replicated cyclic planar and complex motions in cadaveric specimens. Moreover, the dependence of muscle forces on the hand orientation and the direction of circumduction could be vital in the specification of such parameters during wrist rehabilitation.
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Affiliation(s)
- Darshan S Shah
- Department of Bioengineering, Imperial College London, London, United Kingdom.
| | - Claire Middleton
- Department of Hand Surgery, Chelsea and Westminster Hospital, London, United Kingdom.
| | - Sabahat Gurdezi
- Department of Hand Surgery, Chelsea and Westminster Hospital, London, United Kingdom.
| | - Maxim D Horwitz
- Department of Hand Surgery, Chelsea and Westminster Hospital, London, United Kingdom.
| | - Angela E Kedgley
- Department of Bioengineering, Imperial College London, London, United Kingdom.
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11
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Shah DS, Kedgley AE. Control of a wrist joint motion simulator: A phantom study. J Biomech 2016; 49:3061-3068. [PMID: 27448497 PMCID: PMC5061070 DOI: 10.1016/j.jbiomech.2016.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 07/01/2016] [Accepted: 07/05/2016] [Indexed: 01/12/2023]
Abstract
The presence of muscle redundancy and co-activation of agonist-antagonist pairs in vivo makes the optimization of the load distribution between muscles in physiologic joint simulators vital. This optimization is usually achieved by employing different control strategies based on position and/or force feedback. A muscle activated physiologic wrist simulator was developed to test and iteratively refine such control strategies on a functional replica of a human arm. Motions of the wrist were recreated by applying tensile loads using electromechanical actuators. Load cells were used to monitor the force applied by each muscle and an optical motion capture system was used to track joint angles of the wrist in real-time. Four control strategies were evaluated based on their kinematic error, repeatability and ability to vary co-contraction. With kinematic errors of less than 1.5°, the ability to vary co-contraction, and without the need for predefined antagonistic forces or muscle force ratios, novel control strategies - hybrid control and cascade control - were preferred over standard control strategies - position control and force control. Muscle forces obtained from hybrid and cascade control corresponded well with in vivo EMG data and muscle force data from other wrist simulators in the literature. The decoupling of the wrist axes combined with the robustness of the control strategies resulted in complex motions, like dart thrower׳s motion and circumduction, being accurate and repeatable. Thus, two novel strategies with repeatable kinematics and physiologically relevant muscle forces are introduced for the control of joint simulators.
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Affiliation(s)
- Darshan S Shah
- Department of Bioengineering, Imperial College London, London, United Kingdom.
| | - Angela E Kedgley
- Department of Bioengineering, Imperial College London, London, United Kingdom.
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Zhang J, Lin F, Ding X. Maturation Disparity between Hand-Wrist Bones in a Chinese Sample of Normal Children: An Analysis Based on Automatic BoneXpert and Manual Greulich and Pyle Atlas Assessment. Korean J Radiol 2016; 17:435-42. [PMID: 27134531 PMCID: PMC4842862 DOI: 10.3348/kjr.2016.17.3.435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 02/03/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess the maturation disparity of hand-wrist bones using the BoneXpert system and Greulich and Pyle (GP) atlas in a sample of normal children from China. MATERIALS AND METHODS Our study included 229 boys and 168 girls aged 2-14 years. The bones in the hand and wrist were divided into five groups: distal radius and ulna, metacarpals, proximal phalanges, middle phalanges and distal phalanges. Bone age (BA) was assessed separately using the automatic BoneXpert and GP atlas by two raters. Differences in the BA between the most advanced and retarded individual bones and bone groups were analyzed. RESULTS In 75.8% of children assessed with the BoneXpert and 59.4% of children assessed with the GP atlas, the BA difference between the most advanced and most retarded individual bones exceeded 2.0 years. The BA mean differences between the most advanced and most retarded individual bones were 2.58 and 2.25 years for the BoneXpert and GP atlas methods, respectively. Furthermore, for both methods, the middle phalanges were the most advanced group. The most retarded group was metacarpals for BoneXpert, while metacarpals and the distal radius and ulna were the most retarded groups according to the GP atlas. Overall, the BAs of the proximal and distal phalanges were closer to the chronological ages than those of the other bone groups. CONCLUSION Obvious and regular maturation disparities are common in normal children. Overall, the BAs of the proximal and distal phalanges are more useful for BA estimation than those of the other bone groups.
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Affiliation(s)
- Ji Zhang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.; Department of Radiology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China
| | - Fangqin Lin
- Department of Radiology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200040, China
| | - Xiaoyi Ding
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Eschweiler J, Stromps JP, Fischer M, Schick F, Rath B, Pallua N, Radermacher K. A biomechanical model of the wrist joint for patient-specific model guided surgical therapy: Part 2. Proc Inst Mech Eng H 2016; 230:326-34. [DOI: 10.1177/0954411916635443] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An enhanced musculoskeletal biomechanical model of the wrist joint is presented in this article. The computational model is based on the multi-body simulation software AnyBody. Multi body dynamic musculoskeletal models capable of predicting muscle forces and joint contact pressures simultaneously would be valuable for studying clinical issues related to wrist joint degeneration and restoration. In this study, the simulation model of the wrist joint was used for investigating deeper the biomechanical function of the wrist joint. In representative physiological scenarios, the joint behavior and muscle forces were computed. Furthermore, the load transmission of the proximal wrist joint was investigated. The model was able to calculate the parameters of interest that are not easily obtainable experimentally, such as muscle forces and proximal wrist joint forces. In the case of muscle force investigation, the computational model was able to accurately predict the computational outcome for flexion and extension motion. In the case of force distribution of the proximal wrist joint, the model was able to predict accurately the computational outcome for an axial load of 140 N. The presented model and approach of using a multi-body simulation model are anticipated to have value as a predictive clinical tool including effect of injuries or anatomical variations and initial outcome of surgical procedures for patient-specific planning and custom implant design. Therefore, patient-specific multi-body simulation models are potentially valuable tools for surgeons in pre- and intraoperative planning of implant placement and orientation.
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Affiliation(s)
- Jörg Eschweiler
- Helmholtz-Institute for Biomedical Engineering, Chair of Medical Engineering, RWTH Aachen University, Aachen, Germany
- Department of Orthopaedic, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Jan-Philipp Stromps
- Department of Plastic Surgery, Hand and Burns Surgery, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Maximilian Fischer
- Helmholtz-Institute for Biomedical Engineering, Chair of Medical Engineering, RWTH Aachen University, Aachen, Germany
| | - Fabian Schick
- Helmholtz-Institute for Biomedical Engineering, Chair of Medical Engineering, RWTH Aachen University, Aachen, Germany
| | - Björn Rath
- Department of Orthopaedic, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Norbert Pallua
- Department of Plastic Surgery, Hand and Burns Surgery, University Hospital Aachen, RWTH Aachen University, Aachen, Germany
| | - Klaus Radermacher
- Helmholtz-Institute for Biomedical Engineering, Chair of Medical Engineering, RWTH Aachen University, Aachen, Germany
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Erhart S, Schmoelz W, Lutz M. Clinical and biomechanical investigation of an increased articular cavity depth after distal radius fractures: effect on range of motion, osteoarthrosis and loading patterns. Arch Orthop Trauma Surg 2013; 133:1249-55. [PMID: 23748797 DOI: 10.1007/s00402-013-1787-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Indexed: 02/09/2023]
Abstract
INTRODUCTION After fracture, distal radius malunion with dissociation of the volar and dorsal ulnar fracture fragments can lead to an increased articular cavity. PATIENTS AND METHODS To investigate its clinical impact we retrospectively analyzed the outcome of 81 patients and simulated this form of malunion in a biomechanical experiment with six cadaver specimens in a dynamic loading set-up. RESULTS In clinics, a higher arthritis stage was significantly correlated with an increased articular cavity depth and an increased anterioposterior distance. In cadaver specimens, a significantly decreased range of motion and significantly altered intraarticular contact characteristics were recognized for an increased cavity. CONCLUSION Alterations in contact biomechanics could be one reason for the higher incidence of posttraumatic osteoarthritis when a deeper central impaction of the distal radius is present. From a clinical and experimental point of view, restoration of the normal shape of the distal radius is considered to minimize the risk for posttraumatic radiocarpal osteoarthritis.
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Affiliation(s)
- S Erhart
- Department for Trauma Surgery, Medical University Innsbruck, Anichstrasse 35, Innsbruck, Tyrol, Austria.
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