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Li J, Rath B, Hildebrand F, Eschweiler J. Wrist Bone Motion during Flexion-Extension and Radial-Ulnar Deviation: An MRI Study. Life (Basel) 2022; 12:life12101458. [PMID: 36294894 PMCID: PMC9605103 DOI: 10.3390/life12101458] [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: 08/24/2022] [Revised: 09/10/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
The wrist joint plays a vital role in activities of daily living. Clinical applications, e.g., therapeutic planning, prosthesis design, and wrist biomechanical analysis, require a detailed understanding of wrist maneuvers and motion. The lack of soft tissue information, motion analysis on limited carpal bones, etc., restrain the investigation of wrist kinematics. In this study, we established 3D models of carpal bones with their cartilages, and revealed the helical axes (HA) of all eight carpal bones for the first time. Both left and right hands at different positions of flexion-extension (FE) and radial-ulnar deviation (RUD) from five subjects were in-vivo imaged through a magnetic resonance imaging device. We segmented all of the bones, including cartilage information in the wrist joint, after which we explored the kinematics of all carpal bones with the HA method. The results showed that the HA of all carpal bones for FE bounded tightly and was mainly located slightly above the radius. During the RUD, carpal bones in the distal row rotated along with wrist movement while the scaphoid, lunate, and triquetrum primarily flexed and extended. Further results reported that the carpal bones translated greater in RUD than in FE. With the generation of more delicate wrist models and thorough investigations of carpal motion, a better understanding of wrist kinematics was obtained for further pathologic assessment and surgical treatment.
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Affiliation(s)
- Jianzhang Li
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany
- Correspondence: ; Tel.: +49-(0)-241-80-88386
| | - Björn Rath
- Department of Orthopaedic Surgery, Klinikum Wels-Grieskirchen, 4600 Wels, Austria
| | - Frank Hildebrand
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany
| | - Jörg Eschweiler
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany
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Patel A, Massand S, Ingraham J. The state of remote learning in plastic surgery: A systematic review of modalities. SURGERY IN PRACTICE AND SCIENCE 2022. [DOI: 10.1016/j.sipas.2022.100102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Eschweiler J, Migliorini F. Reply to Nikolaidis, P.T.; Afonso, J. Comment on "Eschweiler et al. Anatomy, Biomechanics, and Loads of the Wrist Joint. Life 2022, 12, 188". Life (Basel) 2022; 12:1174. [PMID: 36013353 PMCID: PMC9410372 DOI: 10.3390/life12081174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023] Open
Abstract
Pantelis Nikolaidis and Jose Afonso published a letter [...].
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Ji C, Li J, Praster M, Rath B, Hildebrand F, Eschweiler J. Smoothing the Undersampled Carpal Bone Model with Small Volume and Large Curvature: A Feasibility Study. Life (Basel) 2022; 12:life12050770. [PMID: 35629436 PMCID: PMC9145375 DOI: 10.3390/life12050770] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/10/2022] [Accepted: 05/18/2022] [Indexed: 12/27/2022] Open
Abstract
The carpal bones are eight small bones with irregularities and high curvature on their surfaces. The 3D model of the carpal bone serves as the foundation of further clinical applications, e.g., wrist kinematic behavior. However, due to the limitation of the Magnetic Resonance Imaging (MRI) technique, reconstructed carpal bone models are discretely undersampled, which has dramatic stair-step effects and leads to abnormal meshes on edges or surfaces, etc. Our study focuses on determining the viability of various smoothing techniques for a carpal model reconstructed by in vivo gathered MR images. Five algorithms, namely the Laplacian smoothing algorithm, the Laplacian smoothing algorithm with pre-dilation, the scale-dependent Laplacian algorithm, the curvature flow algorithm, and the inverse distance algorithm, were chosen for evaluation. The assessment took into account the Relative Volume Difference and the Hausdorff Distance as well as the surface quality and the preservation of morphological and morphometric properties. For the five algorithms, we analyzed the Relative Volume Difference and the Hausdorff Distance for all eight carpal bones. Among all the algorithms, the scale-dependent Laplacian method processed the best result regarding surface quality and the preservation of morphological and morphometric properties. Based on our extensive examinations, the scale-dependent Laplacian algorithm is suitable for the undersampled carpal bone model with small volume and large curvature.
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Affiliation(s)
- Chengcheng Ji
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (C.J.); (M.P.); (F.H.); (J.E.)
| | - Jianzhang Li
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (C.J.); (M.P.); (F.H.); (J.E.)
- Correspondence: ; Tel.: +49-(0)-241-808-8386
| | - Maximilian Praster
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (C.J.); (M.P.); (F.H.); (J.E.)
| | - Björn Rath
- Department of Orthopaedic Surgery, Klinikum Wels-Grieskirchen, 4600 Wels, Austria;
| | - Frank Hildebrand
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (C.J.); (M.P.); (F.H.); (J.E.)
| | - Jörg Eschweiler
- Department of Orthopaedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (C.J.); (M.P.); (F.H.); (J.E.)
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Musculoskeletal Modeling of the Wrist via a Multi Body Simulation. Life (Basel) 2022; 12:life12040581. [PMID: 35455073 PMCID: PMC9031395 DOI: 10.3390/life12040581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 12/23/2022] Open
Abstract
In this study, three different musculoskeletal modeling approaches were compared to each other. The objective was to show the possibilities in the case of a simple mechanical model of the wrist, using a simple multi-body-simulation (MBS) model, and using a more complex and patient-specific adaptable wrist joint MBS model. Musculoskeletal modeling could be a useful alternative, which can be practiced as a non-invasive approach to investigate body motion and internal loads in a wide range of conditions. The goal of this study was the introduction of computer-based modelling of the physiological wrist with (MBS-) models focused on the muscle and joint forces acting on the wrist.
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Anatomy, Biomechanics, and Loads of the Wrist Joint. Life (Basel) 2022; 12:life12020188. [PMID: 35207475 PMCID: PMC8880601 DOI: 10.3390/life12020188] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/15/2021] [Accepted: 01/11/2022] [Indexed: 02/05/2023] Open
Abstract
The wrist is by far the most differentiated section of the musculoskeletal system. The spectrum of wrist injuries ranges from minor injuries to complex traumas with simultaneous loss of functions, resulting in enormous economic costs. A proper understanding of the anatomy and biomechanics is essential for effective treatment, whether conservative or surgical; this applies to the wrist no less than to other parts of the human body. Here; information on the wrist anatomy; kinematics; and biomechanical behavior is presented, commencing with a brief explanation of the structure of its hard and soft tissues. Eight carpal bones in combination with two forearm bones (radius and ulna) construct the wrist joint. The motion of the wrist joint is initiated by the muscles of the forearm, and strong and short ligaments ensure the stability of the wrist. All of these components are essential to bringing functions to the wrist joint because these structures allow wrist mobility and sustainability. In addition, the kinematics of the wrist joint is presented and different biomechanical model approaches. The therapeutic (surgical) restoration of the balance between the load–bearing capacity and the actual stress on a joint is the prerequisite for a lifelong and trouble-free function of a joint. Regarding the complex clinical problems, however, a valid biomechanical wrist joint model would be necessary as assistance, to improve the success of systematized therapies based on computer–aided model–based planning and intervention.
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Marqués R, Melchor J, Sánchez-Montesinos I, Roda O, Rus G, Hernández-Cortés P. Biomechanical Finite Element Method Model of the Proximal Carpal Row and Experimental Validation. Front Physiol 2022; 12:749372. [PMID: 35140623 PMCID: PMC8819096 DOI: 10.3389/fphys.2021.749372] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022] Open
Abstract
The Finite Element Method (FEM) models are valuable tools to create an idea of the behavior of any structure. The complexity of the joints, materials, attachment areas, and boundary conditions is an open issue in biomechanics that needs to be addressed. Scapholunate instability is the leading cause of wrist pain and disability among patients of all ages. It is needed a better understanding of pathomechanics to develop new effective treatments. Previous models have emulated joints like the ankle or the knee but there are few about the wrist joint. The elaboration of realistic computational models of the carpus can give critical information to biomedical research and surgery to develop new surgical reconstructions. Hence, a 3D model of the proximal carpal row has been created through DICOM images, making a reduced wrist model. The materials, contacts, and ligaments definition were made via open-source software to extract results and carry on a reference comparison. Thus, considering the limitations that a reduced model could carry on (unbalanced forces and torques), the stresses that result in the scapholunate interosseous ligament (SLIL) lead us to a bones relative displacement, which support the kinematics hypothesis in the literature as the distal carpal row moves as a rigid solid with the capitate bone. Also, experimental testing is performed, successfully validating the linear strength values of the scapholunate ligament from the literature.
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Affiliation(s)
- Rafael Marqués
- Department of Structural Mechanics, University of Granada, Granada, Spain
| | - Juan Melchor
- Department of Statistics and Operations Research, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain
- Excellence Research Unit “Modeling Nature”, University of Granada, Granada, Spain
- *Correspondence: Juan Melchor
| | | | - Olga Roda
- Department of Anatomy and Human Embryology, University of Granada, Granada, Spain
| | - Guillermo Rus
- Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain
- Excellence Research Unit “Modeling Nature”, University of Granada, Granada, Spain
- Department of Structural Mechanics, University of Granada, Granada, Spain
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Motion preservation surgery for scoliosis with a vertebral body tethering system: a biomechanical study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2021; 31:1013-1021. [PMID: 34716821 DOI: 10.1007/s00586-021-07035-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/08/2021] [Accepted: 10/14/2021] [Indexed: 01/02/2023]
Abstract
PURPOSE There is a paucity of studies on new vertebral body tethering (VBT) surgical constructs especially regarding their potentially motion-preserving ability. This study analyses their effects on the ROM of the spine. METHODS Human spines (T10-L3) were tested under pure moment in four different conditions: (1) native, (2) instrumented with one tether continuously connected in all vertebrae from T10 to L3, (3) additional instrumented with a second tether continuously connected in all vertebrae from T11 to L3, and (4) instrumented with one tether and one titanium rod (hybrid) attached to T12, L1 and L2. The instrumentation was inserted in the left lateral side. The intersegmental ROM was evaluated using a magnetic tracking system, and the medians were analysed. Please check and confirm the author names and initials are correct. Also, kindly confirm the details in the metadata are correct. The mentioned information is correct RESULTS: Compared to the native spine, the instrumented spine presented a reduction of less than 13% in global ROM considering flexion-extension and axial rotation. For left lateral bending, the median global ROM of the native spine (100%) significantly reduced to 74.6%, 66.4%, and 68.1% after testing one tether, two tethers and the hybrid construction, respectively. In these cases, the L1-L2 ROM was reduced to 68.3%, 58.5%, and 38.3%, respectively. In right lateral bending, the normalized global ROM of the spine with one tether, two tethers and the hybrid construction was 58.9%, 54.0%, and 56.6%, respectively. Considering the same order, the normalized L1-L2 ROM was 64.3%, 49.9%, and 35.3%, respectively. CONCLUSION The investigated VBT techniques preserved global ROM of the spine in flexion-extension and axial rotation while reduced the ROM in lateral bending.
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Li J, Nebelung S, Schock J, Rath B, Tingart M, Liu Y, Siroros N, Eschweiler J. A Novel Combined Level Set Model for Carpus Segmentation from Magnetic Resonance Images with Prior Knowledge aligned in Polar Coordinate System. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 208:106245. [PMID: 34247119 DOI: 10.1016/j.cmpb.2021.106245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Segmentation on carpus provides essential information for clinical applications including pathological evaluations, therapy planning, wrist biomechanical analysis, etc. Along with the acquisition procedure of magnetic resonance (MR) technique, poor quality of wrist images (e.g., occlusion, low signal-to-noise ratio, and contrast) often causes segmentation failure. METHODS In this work, to address such problems, a shape prior enhanced level set model was proposed. By transferring a shape contour in Cartesian Coordinate System (COS) into a curve in Polar Coordinate System (POS), parameters describing conventional shape invariance, i.e., translations, rotation, and scale were simplified into a single parameter for phase shift, which strongly improved algorithm efficiency. Given a training set in COS, a confidence interval representing the corresponding curves in POS was utilized as the shape prior set term in the model. Integrated with an edge detector, a local intensity descriptor, and a regularization term, the proposed method further possessed abilities against noise, intensity inhomogeneity as well as re-initialization problem. Images from 15 in-vivo acquired MR-datasets of the human wrist were used for validation. The performance of the proposed method has been compared with three state-of-the-art methods. RESULTS We reported a Dice Similarity Coefficient of 96.88±1.20%, a Relative Volume Difference of -1.53±3.01%, a Volume Overlap Error of 6.03±2.23%, a 95% Hausdorff Distance of 1.43±0.66 mm, an Average Symmetric Surface Distance of 0.50±0.17 mm, and a Root Mean Square Distance of 0.71±0.25 mm for the proposed method. The time consumption was 36.03±19.98 s. CONCLUSIONS Experimental results indicated that, compared with three other methods, the proposed method achieved significant improvement in terms of accuracy and efficiency.
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Affiliation(s)
- Jianzhang Li
- Department of Orthopaedic Surgery, RWTH Aachen University Clinic, Aachen, Germany.
| | - Sven Nebelung
- Institute of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Justus Schock
- Institute of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Björn Rath
- Department of Orthopaedic Surgery, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Markus Tingart
- Department of Orthopaedic Surgery, RWTH Aachen University Clinic, Aachen, Germany
| | - Yu Liu
- Department of Orthopaedic Surgery, RWTH Aachen University Clinic, Aachen, Germany
| | - Nad Siroros
- Department of Orthopaedic Surgery, RWTH Aachen University Clinic, Aachen, Germany
| | - Jörg Eschweiler
- Department of Orthopaedic Surgery, RWTH Aachen University Clinic, Aachen, Germany
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Melzner M, Engelhardt L, Simon U, Dendorfer S. Electromyography Based Validation of a Musculoskeletal Hand Model. J Biomech Eng 2021; 144:1115820. [PMID: 34386814 DOI: 10.1115/1.4052115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Indexed: 11/08/2022]
Abstract
Regarding the prevention of injuries and rehabilitation of the human hand, musculoskeletal simulations using an inverse dynamics approach allow for insights of the muscle recruitment and thus acting forces on the hand. Currently, several hand models from various research groups are in use, which are mainly validated by the comparison of numerical and anatomical moment arms. In contrast to this validation and model-building technique by cadaver studies, the aim of the present study is to further validate a recently published hand model [1] by analyzing numerically calculated muscle activities in comparison to experimentally measured electromyographical signals of the muscles. Therefore, the electromyographical signals of 10 hand muscles of five test subjects performing seven different hand movements were measured. The kinematics of these tasks were used as input for the hand model, and the numerical muscle activities were computed. To analyze the relationship between simulated and measured activities, the time difference of the muscle on- and off-set points were calculated, which resulted in a mean on- and off-set time difference of 0.58 s between the experimental data and the model. The largest differences were detected for movements that mainly addressed the wrist. One major issue comparing simulated and measured muscle activities of the hand is cross-talk. Nevertheless, the results show that the hand model fits the experiment quite accurately despite some limitations and is a further step towards patient-specific modelling of the upper extremity.
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Affiliation(s)
- Maximilian Melzner
- Laboratory for Biomechanics, OTH Regensburg, Germany and Regensburg Center of Biomedical Engineering, Germany, Galgenbergstr. 30, 93053 Regensburg, Germany
| | - Lucas Engelhardt
- Scientific Computing Centre Ulm (UZWR), Ulm University, Germany and Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm, Germany, Helmholtzstr. 20, 89081 Ulm, Germany
| | - Ulrich Simon
- Scientific Computing Centre Ulm (UZWR), Ulm University, Germany, Helmholtzstr. 20, 89081 Ulm, Germany
| | - Sebastian Dendorfer
- Laboratory for Biomechanics, OTH Regensburg, Germany and Regensburg Center of Biomedical Engineering, Germany, Laboratory for Biomechanics, OTH Regensburg, Galgenbergstr. 30, 93053 Regensburg, Germany
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Akinnola OO, Vardakastani V, Kedgley AE. Development of a clinically adoptable joint coordinate system for the wrist. J Biomech 2021; 118:110291. [PMID: 33582599 DOI: 10.1016/j.jbiomech.2021.110291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 01/16/2021] [Accepted: 01/23/2021] [Indexed: 10/22/2022]
Abstract
Kinematics play a vital role in answering both clinical and research questions regarding joint biomechanics. Standardisation of kinematic approaches is important; however, the method that is currently recommended for building the joint coordinate system (JCS) to measure kinematics of the wrist is difficult to implement in vivo. In this study, a series of JCSs were examined and compared to the International Society of Biomechanics (ISB) recommendations in terms of landmark digitisation repeatability, coordinate frame creation repeatability, and secondary rotations during planar motion. No differences were found between the ISB JCS and 338 of 408 of the JCSs proposed in the study, meaning that the proposed alternative can be used without affecting the measured joint angles or repeatability of the JCS. Forearm frames that used a vector between the epicondyles to define the YZ plane of the forearm were found to create JCSs that produced secondary rotations greater than that which would be clinically detectable and thus, they should be avoided when defining a JCS. The remaining 338 coordinate systems can be used interchangeably; consequently, should there be any clinical limitations that result in missing landmarks, alternative coordinate systems can be used. A joint coordinate system created using the radial styloid, ulnar styloid, medial epicondyle, lateral epicondyle, the heads of the second and fifth metacarpal, and the base of the third metacarpal is recommended for quantifying kinematics in vivo.
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Affiliation(s)
| | | | - Angela E Kedgley
- Department of Bioengineering, Imperial College London, London, United Kingdom.
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Mechanical performance comparison of two surgical constructs for wrist four-corner arthrodesis via dorsal and radial approaches. Clin Biomech (Bristol, Avon) 2021; 82:105274. [PMID: 33508561 DOI: 10.1016/j.clinbiomech.2021.105274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/06/2021] [Accepted: 01/11/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Four-corner arthrodesis, which involves fusing four carpal bones while removing the scaphoid bone, is a standard surgery for the treatment of advanced stages of wrist arthritis. Nowadays, it can be performed using a dorsal approach by fixing a plate to the bones and a new radial approach is in development. To date, there is no consensus on the biomechanically optimal and most reliable surgical construct for four-corner arthrodesis. METHODS To evaluate them biomechanically and thus assist the surgeon in choosing the best implant orientation, radial or dorsal, the two different four-corner arthrodesis surgical constructs were virtually simulated on a 3D finite element model representing all major structures of the wrist. Two different realistic load sets were applied to the model, representing common tasks for the elderly. FINDINGS Results consistency was assessed by comparing with the literature the force magnitude computed on the carpal bones. The Von Mises stress distribution in the radial and dorsal plates were calculated. Stress concentration was located at the plate-screw interface for both surgical constructs, with a maximum stress value of 413 MPa for the dorsal plate compared to 326 MPa for the radial plate, meaning that the stress levels are more unfavourable in the dorsal approach. INTERPRETATION Although some bending stress was found in one load case, the radial plate was mechanically more robust in the other load case. Despite some limitations, this study provides, for the first time, quantified evidence that the newly developed radial surgical construct is mechanically as efficient as the dorsal surgical construct.
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Engelhardt L, Melzner M, Havelkova L, Fiala P, Christen P, Dendorfer S, Simon U. A new musculoskeletal AnyBody™ detailed hand model. Comput Methods Biomech Biomed Engin 2020; 24:1-11. [PMID: 33300810 DOI: 10.1080/10255842.2020.1851367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 10/13/2020] [Accepted: 11/11/2020] [Indexed: 10/22/2022]
Abstract
Musculoskeletal research questions regarding the prevention or rehabilitation of the hand can be addressed using inverse dynamics simulations when experiments are not possible. To date, no complete human hand model implemented in a holistic human body model has been fully developed. The aim of this work was to develop, implement, and validate a fully detailed hand model using the AnyBody Modelling System (AMS) (AnyBody, Aalborg, Denmark). To achieve this, a consistent multiple cadaver dataset, including all extrinsic and intrinsic muscles, served as a basis. Various obstacle methods were implemented to obtain with the correct alignment of the muscle paths together with the full range of motion of the fingers. These included tori, cylinders, and spherical ellipsoids. The origin points of the lumbrical muscles within the tendon of the flexor digitorum profundus added a unique feature to the model. Furthermore, the possibility of an entire patient-specific scaling based on the hand length and width were implemented in the model. For model validation, experimental datasets from the literature were used, which included the comparison of numerically calculated moment arms of the wrist, thumb, and index finger muscles. In general, the results displayed good comparability of the model and experimental data. However, the extrinsic muscles showed higher accordance than the intrinsic ones. Nevertheless, the results showed, that the proposed developed inverse dynamics hand model offers opportunities in a broad field of applications, where the muscles and joint forces of the forearm play a crucial role.
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Affiliation(s)
- Lucas Engelhardt
- Scientific Computing Centre Ulm (UZWR), Ulm University, Ulm, Germany
| | - Maximilian Melzner
- Laboratory for Biomechanics, Ostbayerische Technische Hochschule (OTH) Regensburg, Regensburg, Germany
- Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Regensburg, Germany
| | - Linda Havelkova
- New Technologies Research Centre, University of West Bohemia (UWB), Plzen, Czech Republic
| | - Pavel Fiala
- Department of Anatomy, Faculty of Medicine in Pilsen, Charles University, Plzen, Czech Republic
| | - Patrik Christen
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
- Institute for Information Systems, University of Applied Sciences and Arts Northwestern, Brugg, Switzerland
| | - Sebastian Dendorfer
- Laboratory for Biomechanics, Ostbayerische Technische Hochschule (OTH) Regensburg, Regensburg, Germany
- Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Regensburg, Germany
| | - Ulrich Simon
- Scientific Computing Centre Ulm (UZWR), Ulm University, Ulm, Germany
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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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15
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Badash I, Burtt K, Solorzano CA, Carey JN. Innovations in surgery simulation: a review of past, current and future techniques. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:453. [PMID: 28090509 DOI: 10.21037/atm.2016.12.24] [Citation(s) in RCA: 156] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future. Evidence from the literature highlights the benefits of including simulations in surgical training; skills acquired through simulations translate into improvements in operating room performance. Moreover, simulations are rapidly incorporating new medical technologies and offer increasingly high-fidelity recreations of procedures. As a result, both novice and expert surgeons are able to benefit from their use. As dedicated, structured curricula are developed that incorporate simulations into daily resident training, simulated surgeries will strengthen the surgeon's skill set, decrease hospital costs, and improve patient outcomes.
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Affiliation(s)
- Ido Badash
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Karen Burtt
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Carlos A Solorzano
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Joseph N Carey
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA
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16
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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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