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Yoneda H, Iwatsuki K, Saeki M, Murayama A, Takahashi N, Yamamoto M, Hirata H. Quantitative Measurement of Rotation in Phalangeal Fracture Malunion Using Computed Tomography Imaging-"Linkage Simulation". Diagnostics (Basel) 2024; 14:1818. [PMID: 39202306 PMCID: PMC11353832 DOI: 10.3390/diagnostics14161818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2024] [Revised: 08/08/2024] [Accepted: 08/13/2024] [Indexed: 09/03/2024] Open
Abstract
Malunion of thumb and finger fractures causes problems in the cosmetic and functional aspects of the hand. Malunion of phalangeal fractures usually manifests as a combination of rotational deformities in the coronal, sagittal, and transverse planes, and corrective osteotomy is performed on the planes that cause these problems. Quantification of the deformity is essential for precise osteotomy and is difficult to perform in the transverse plane, even with radiography or computed tomography. Thus, we developed a technique called linkage simulation for the quantitative measurement of rotational deformities for surgical planning. In this procedure, finger extension and flexion can be simulated based on the predicted rotational axis of the joint, which is useful for determining the appropriate correction. Furthermore, by performing a reduction simulation in the software, it is possible to simulate the surgery and predict the postoperative results. This paper reports the details of this technique.
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Affiliation(s)
- Hidemasa Yoneda
- Department of Human Enhancement and Hand Surgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
- Department of Limb Traumatology, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
- Department of Orthopedics, Aichi Medical University, 1-1 Yazakokarimata, Nagakute 480-1195, Japan
| | - Katsuyuki Iwatsuki
- Department of Human Enhancement and Hand Surgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Masaomi Saeki
- Department of Human Enhancement and Hand Surgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Atsuhiko Murayama
- Department of Limb Traumatology, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Nobunori Takahashi
- Department of Orthopedics, Aichi Medical University, 1-1 Yazakokarimata, Nagakute 480-1195, Japan
| | - Michiro Yamamoto
- Department of Human Enhancement and Hand Surgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Hitoshi Hirata
- Department of Human Enhancement and Hand Surgery, Nagoya University, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
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Munyebvu TA, Metcalf CD, Burson-Thomas CB, Warwick D, Everitt C, King L, Darekar A, Browne M, Heller MOW, Dickinson AS. OpenHands: An Open-Source Statistical Shape Model of the Finger Bones. Ann Biomed Eng 2024:10.1007/s10439-024-03560-7. [PMID: 38960974 DOI: 10.1007/s10439-024-03560-7] [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: 12/21/2023] [Accepted: 06/10/2024] [Indexed: 07/05/2024]
Abstract
This paper presents statistical shape models of the four fingers of the hand, with an emphasis on anatomic analysis of the proximal and distal interphalangeal joints. A multi-body statistical shape modelling pipeline was implemented on an exemplar training dataset of computed tomography (CT) scans of 10 right hands (5F:5M, 27-37 years, free from disease or injury) imaged at 0.3 mm resolution, segmented, meshed and aligned. Model generated included pose neutralisation to remove joint angle variation during imaging. Repositioning was successful; no joint flexion variation was observed in the resulting model. The first principal component (PC) of morphological variation represented phalanx size in all fingers. Subsequent PCs showed variation in position along the palmar-dorsal axis, and bone breadth: length ratio. Finally, the models were interrogated to provide gross measures of bone lengths and joint spaces. These models have been published for open use to support wider community efforts in hand biomechanical analysis, providing bony anatomy descriptions whilst preserving the security of the underlying imaging data and privacy of the participants. The model describes a small, homogeneous population, and assumptions cannot be made about how it represents individuals outside the training dataset. However, it supplements anthropometric datasets with additional shape information, and may be useful for investigating factors such as joint morphology and design of hand-interfacing devices and products. The model has been shared as an open-source repository ( https://github.com/abel-research/OpenHands ), and we encourage the community to use and contribute to it.
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Affiliation(s)
| | | | | | - D Warwick
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - C Everitt
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - L King
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A Darekar
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - M Browne
- University of Southampton, Southampton, UK
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Yu J, Luo L, Zhu W, Li Y, Xie P, Zhang L. A Novel Low-Pressure Robotic Glove Based on CT-Optimized Finger Joint Kinematic Model for Long-Term Rehabilitation of Stroke Patients. IEEE Trans Neural Syst Rehabil Eng 2024; 32:53-62. [PMID: 38032787 DOI: 10.1109/tnsre.2023.3337827] [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: 12/02/2023]
Abstract
Wearing robotic gloves has become increasingly crucial for hand rehabilitation in stroke patients. However, traditional robotic gloves can exert additional pressure on the hand, such as prolonged use leading to poor blood circulation and muscle stiffness. To address these concerns, this work analyzes the finger kinematic model based on computerized tomography (CT) images of human hands, and designs a low-pressure robotic glove that conforms to finger kinematic characteristics. Firstly, physiological data on finger joint flexion and extension were collected through CT scans. The equivalent rotation centers of finger joints were obtained using the SURF and RANSAC algorithms. Furthermore, the trajectory of finger joint end and the correlation equation of finger joint motion were fitted, and a comprehensive finger kinematic model was established. Based on this finger kinematic model, a novel under-actuated exoskeleton mechanism was designed using a human-machine integration approach. The novel robotic glove fully aligns with the equivalent rotation centers and natural motion trajectories of the fingers, exerting minimal and evenly distributed dynamic pressure on the fingers, with a theoretical static pressure value of zero. Experiments involving gripping everyday objects demonstrated that the novel robotic glove significantly reduces the overall pressure on the fingers during grasping compared to the pneumatic glove and the traditional exoskeleton robotic glove. It is suitable for long-term use by stroke patients for rehabilitation training.
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Bärtschi N, Scheibler AG, Schweizer A. Palmar Shift of the Proximal Interphalangeal Joint in Different Grip Positions as a Potential Risk Factor for Periphyseal Injuries in Adolescent Climbers. Wilderness Environ Med 2023; 34:451-456. [PMID: 37550105 DOI: 10.1016/j.wem.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 06/01/2023] [Accepted: 06/27/2023] [Indexed: 08/09/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate different grip positions as a contributing factor for primary periphyseal stress injuries of the finger phalanges in climbing. METHODS Ultrasound imaging of the proximal interphalangeal joint was performed on 37 asymptomatic adolescent climbers. Longitudinal images were obtained of middle and ring fingers of both hands in different grip positions (open, half-open, and crimp), unloaded and loaded. The translation between the dorsal head of the proximal phalanx and the shaft of the middle phalanx was measured in an unloaded and loaded situation for all grip positions. The resulting difference was determined as the palmar shift. RESULTS The mean age of the study population was 13 y. Results showed a palmar shift of 0.57 mm in a loaded crimp grip position compared to 0.13 mm in an open position and 0.20 mm in a half-open grip position. With a P value of <0.001, this shift was significantly higher in a crimp grip position compared to open or half-open grip positions. CONCLUSIONS This leads to an increase in joint incongruity and much higher peak forces on the dorsal aspect of the epiphyseal-physeal-metaphyseal complex, which is particularly vulnerable during the adolescent growth spurt. Thus, climbing and training behavior should be adapted accordingly during this phase by avoiding the crimp grip position until epiphyseal fusion.
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Affiliation(s)
- Natalie Bärtschi
- Department of Orthopedics, Balgrist University Hospital, Zurich, Switzerland
| | - Anne-Gita Scheibler
- Department of Orthopedics, Balgrist University Hospital, Zurich, Switzerland
| | - Andreas Schweizer
- Department of Orthopedics, Balgrist University Hospital, Zurich, Switzerland.
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Zumbrunn Wojczyńska A, Markova M, Ettlin DA, Gallo LM, Colombo V. In-vivo kinematic assessment of alloplastic temporomandibular joint replacements by means of helical axis: A cohort study with historical control. J Biomech 2021; 122:110494. [PMID: 33991898 DOI: 10.1016/j.jbiomech.2021.110494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 11/18/2022]
Abstract
Alloplastic total temporomandibular joint replacement (TJR) is a surgical procedure used to restore normal mandibular function when conservative therapies fail. The instantaneous helical axis (HA), is a mathematical model used to visualize globally rigid body kinematics. It can be applied to mandibular motion for quantification of movement patterns and irregularities. Aim of this study was to analyze HA pathways in subjects with unilateral and bilateral TJR and compare them to a control group. An optoelectronic system was employed to track mouth opening/closing cycles (n = 3) of 15 patients (7 operated unilaterally, 8 bilaterally, 11 F, aged 24-72) and 12 controls (6 F, aged 23-40). HA position in space was determined for 30 equally-distributed steps of the observed movement. Total mandibular rotation around HA (Φtot) and total translation along HA (Ttot) were determined. Angles between HA and the anatomical coordinate system of the head (θx, θy, θz); global fluctuation of HA spatial orientation (θe), distance between condylar center (CP) and HA (dCP) and its projections on the axes (xdCP, ydCP, zdCP) were calculated. Overall, Φtot was larger in controls than in bilaterally operated subjects (p = 0.002, p = 0.003) and θz was larger in unilaterally operated subjects than in controls (p = 0.004) and bilaterally operated subjects (p = 0.002, p = 0.024). During opening, θe¯ was smaller in controls than in unilaterally operated subjects (p = 0.01). The distance dCP was smaller for alloplastic joints than for controls (p < 0.01 overall). In conclusion, mandibular HA pathways in patients with TJR differ significantly from controls in terms of spatial location and variability.
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Affiliation(s)
| | - Michala Markova
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Switzerland
| | - Dominik A Ettlin
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Switzerland
| | - Luigi M Gallo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Switzerland
| | - Vera Colombo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, Switzerland.
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Gyroscope Sensor Based In Vivo Finger Axes of Rotation Identification Using Screw Displacement. Appl Bionics Biomech 2021; 2021:8871593. [PMID: 33628333 PMCID: PMC7892214 DOI: 10.1155/2021/8871593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/29/2020] [Accepted: 01/20/2021] [Indexed: 11/23/2022] Open
Abstract
This paper presents a low-cost, efficient, and portable in vivo method for identifying axes of rotation of the proximal interphalangeal and distal interphalangeal joints in an index finger. The approach is associated with the screw displacement representation of rigid body motion. Using the matrix exponential method, a detailed derivation of general spatial displacement of a rigid body in the form of screw displacement including the Rodrigues' formulae for rotation is presented. Then, based on a gyroscope sensor, a test framework for determining axes of rotation of finger joints is established, and experiments on finding the directions of joint axes of the PIP and DIP joints are conducted. The results obtained highly agree with those presented in literature through traditional but complex methods.
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Quantitative analysis of metacarpophalangeal joints during active flexion using four-dimensional computed tomography. Clin Biomech (Bristol, Avon) 2020; 80:105188. [PMID: 33080527 DOI: 10.1016/j.clinbiomech.2020.105188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 08/27/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The metacarpophalangeal joint has a unique morphology with a high degree of freedom. However, few studies have analyzed the kinematics of fingers owing to the rapid movement of the small bones involved. The in-vivo kinematics of metacarpophalangeal joints were analyzed by four-dimensional computed tomography (4DCT) and associated with its morphology. METHODS The flexion motion of the fingers of bilateral hands in 10 volunteers were examined using 4DCT. Iterative surfaces were registered to trace the surface of the proximal phalanges with respect to metacarpals. Rotation angles were calculated using Euler/Cardan angles. FINDINGS In the index finger, the proximal phalange supinated to a maximum flexion of 40° and then pronated, and its range of rotation was larger than the previous reports. In the other fingers, the proximal phalanges continued to supinate during flexion. The helical axis of the proximal phalange passed a point extremely close to the center point of bilateral condyles, and it moved toward the proximal and palmar directions until the middle stage of flexion and toward the proximal and dorsal directions during the late stage of flexion. The translation of the rotation axis was larger in the ring and little fingers. INTERPRETATION The rotation in the index finger was larger than previously reported. The helical axes moved in the dorsal direction and proximally during the latter phase of the flexion. These results can be employed to better understand the causes of implant failure of the metacarpophalangeal joints.
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Hong SW, Yoon J, Kim YJ, Gong HS. Novel implant design of the proximal interphalangeal joint using an optimized rolling contact joint mechanism. J Orthop Surg Res 2019; 14:212. [PMID: 31299978 PMCID: PMC6624962 DOI: 10.1186/s13018-019-1234-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/11/2019] [Indexed: 11/29/2022] Open
Abstract
Background The aims of this study were to propose a novel implant design for the proximal interphalangeal joint (PIPJ) of the hand using a rolling contact joint (RCJ) mechanism and to derive an optimal implant design based on human PIPJ kinematics. Methods In total, 10 participants with normal PIPJs were enrolled in this study. True lateral finger radiographs were obtained in 10° increments from 0º (full extension) to 120° flexion of PIPJ. Radiographs were used to determine the average center of rotation, which formed the basis of a mathematical expression of the PIPJ kinematics. The variations in extensor tendon excursions in relation to the range of motion of PIPJ were determined using results from previous cadaveric studies. As the next step, a PIPJ implant design using an RCJ mechanism that was most consistent with the mathematically expressed PIPJ kinematics and tendon excursions was determined using a constrained optimization algorithm. Results The final proposed PIPJ implant had a relatively constant center of rotation over the entire PIPJ range of motion among the participants. In addition, the extensor tendon excursions of the proposed implant as applied to the phalangeal bones were similar to those of the human tendon. The proposed PIPJ implant achieved an acceptable position of the RCJ surface on the proximal and middle phalanges, which was derived from the constrained optimization algorithm. Conclusions A novel PIPJ implant design using an RCJ mechanism demonstrated acceptable outcomes in terms of PIPJ human kinematics and tendon excursions.
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Affiliation(s)
- Seok Woo Hong
- Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea
| | - Junsuk Yoon
- Department of Electrical Engineering, Korea University of Technology and Education, 1600, ChungJeol-ro, Dongnam-gu, Cheonan-si, Chungcheongnam-do, 31253, Republic of Korea
| | - Yong-Jae Kim
- Department of Electrical Engineering, Korea University of Technology and Education, 1600, ChungJeol-ro, Dongnam-gu, Cheonan-si, Chungcheongnam-do, 31253, Republic of Korea
| | - Hyun Sik Gong
- Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro, 173-beon-gil, Bundang-gu, Seungnam, 13620, Republic of Korea.
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Abstract
Proximal interphalangeal joint injuries are one of the most common injuries of the hand. The severity of injury can vary from a minor sprain to a complex intra-articular fracture. Because of the complex anatomy of the joint, complications may occur even after an appropriate treatment. This article provides a comprehensive review on existing techniques to manage complications and imparts practical points to help prevent further complications after proximal interphalangeal joint injury.
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Affiliation(s)
- Sirichai Kamnerdnakta
- Department of Surgery, Section of Plastic Surgery, University of Michigan, NCRC, Building 18, G200, 2800 Plymouth Road, Ann Arbor, MI 48109, USA; Division of Plastic Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, 12th Floor, Siamintr Building, Bangkok-noi, Bangkok 10700, Thailand
| | - Helen E Huetteman
- Department of Surgery, Section of Plastic Surgery, University of Michigan, NCRC, Building 18, G200, 2800 Plymouth Road, Ann Arbor, MI 48109, USA
| | - Kevin C Chung
- Section of Plastic Surgery, University of Michigan, 2130 Taubman Center, SPC 5340, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5340, USA.
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Nichols JA, Bednar MS, Wohlman SJ, Murray WM. Connecting the wrist to the hand: A simulation study exploring changes in thumb-tip endpoint force following wrist surgery. J Biomech 2017; 58:97-104. [PMID: 28552412 DOI: 10.1016/j.jbiomech.2017.04.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 03/01/2017] [Accepted: 04/24/2017] [Indexed: 10/19/2022]
Abstract
The wrist is essential for hand function. Yet, due to the complexity of the wrist and hand, studies often examine their biomechanical features in isolation. This approach is insufficient for understanding links between orthopaedic surgery at the wrist and concomitant functional impairments at the hand. We hypothesize that clinical reports of reduced force production by the hand following wrist surgeries can be explained by the surgically-induced, biomechanical changes to the system, even when those changes are isolated to the wrist. This study develops dynamic simulations of lateral pinch force following two common surgeries for wrist osteoarthritis: scaphoid-excision four-corner fusion (SE4CF) and proximal row carpectomy (PRC). Simulations of lateral pinch force production in the nonimpaired, SE4CF, and PRC conditions were developed by adapting published models of the nonimpaired wrist and thumb. Our simulations and biomechanical analyses demonstrate how the increased torque-generating requirements at the wrist imposed by the orthopaedic surgeries influence force production to such an extent that changes in motor control strategy are required to generate well-directed thumb-tip end-point forces. The novel implications of our work include identifying the need for surgeries that optimize the configuration of wrist axes of rotation, rehabilitation strategies that improve post-operative wrist strength, and scientific evaluation of motor control strategies following surgery. Our simulations of SE4CF and PRC replicate surgically-imposed decreases in pinch strength, and also identify the wrist's torque-generating capacity and the adaptability of muscle coordination patterns as key research areas to improve post-operative hand function.
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Affiliation(s)
- Jennifer A Nichols
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA; Shirley Ryan AbilityLab (formerly Rehabilitation Institute of Chicago), Chicago, IL, USA; Edward Hines, Jr. VA Hospital, Hines, IL, USA
| | - Michael S Bednar
- Edward Hines, Jr. VA Hospital, Hines, IL, USA; Department of Orthopaedic Surgery and Rehabilitation, Stritch School of Medicine, Loyola University - Chicago, Maywood, IL, USA
| | - Sarah J Wohlman
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA; Shirley Ryan AbilityLab (formerly Rehabilitation Institute of Chicago), Chicago, IL, USA
| | - Wendy M Murray
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA; Departments of Physical Medicine & Rehabilitation and Physical Therapy & Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Shirley Ryan AbilityLab (formerly Rehabilitation Institute of Chicago), Chicago, IL, USA; Edward Hines, Jr. VA Hospital, Hines, IL, USA.
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