Biomechanics and Pinch Force of the Index Finger Under Simulated Proximal Interphalangeal Arthrodesis

This article presented an assessment of quantitative measures of workspace (WS) attributes under simulated proximal interphalangeal (PIP) joint arthrodesis of the index finger. Seven healthy subjects were tested with the PIP joint unconstrained (UC) and constrained to selected angles using a motion analysis system. A model of the constrained finger was developed in order to address the impact of the inclusion of prescribed joint arthrodesis angles on WS attributes. Model parameters were obtained from system identification experiments involving flexion–extension (FE) movements of the UC and constrained finger. The data of experimental FE movements of the constrained finger were used to generate the two-dimensional (2D) WS boundaries and to validate the model. A weighted criterion was formulated to define an optimal constraint angle among several system parameters. Results indicated that a PIP joint immobilization angle of 40–50 deg of flexion maximized the 2D WS. The analysis of the aspect ratio of the 2D WS indicated that the WS was more evenly distributed as the imposed PIP joint constraint angle increased. With the imposed PIP joint constraint angles of 30 deg, 40 deg, 50 deg, and 60 deg of flexion, the normalized maximum distance of fingertip reach was reduced by approximately 3%, 4%, 7%, and 9%, respectively.

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Fixation of the Proximal Interphalangeal Arthrodesis with the Use of an Intraosseous Loop of Stainless-Steel Wire Suture

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2009.01.012 ◽

2009 ◽

Vol 48 (3) ◽

pp. 411-414 ◽

Cited By ~ 17

Author(s):

William Harris ◽

Gregory A. Mote ◽

D. Scot Malay

Keyword(s):

Stainless Steel ◽

Steel Wire ◽

Stainless Steel Wire ◽

Wire Suture ◽

Interphalangeal Arthrodesis ◽

Proximal Interphalangeal Arthrodesis

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A Simple Method of Intramedullary Fixation for Proximal Interphalangeal Arthrodesis

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2014.03.017 ◽

2014 ◽

Vol 53 (6) ◽

pp. 817-824 ◽

Cited By ~ 9

Author(s):

Michael B. Canales ◽

Mark C. Razzante ◽

Duane J. Ehredt ◽

Coleman O. Clougherty

Keyword(s):

Intramedullary Fixation ◽

Simple Method ◽

Interphalangeal Arthrodesis ◽

Proximal Interphalangeal Arthrodesis

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Measurement Error in Grip and Pinch Force Measurements in Patients With Hand Injuries

Physical Therapy ◽

10.1093/ptj/83.9.806 ◽

2003 ◽

Vol 83 (9) ◽

pp. 806-815 ◽

Cited By ~ 93

Author(s):

Ton AR Schreuders ◽

Marij E Roebroeck ◽

Janine Goumans ◽

Johan F van Nieuwenhuijzen ◽

Theo H Stijnen ◽

...

Keyword(s):

Measurement Error ◽

Grip Force ◽

Index Finger ◽

Medical Center ◽

Intraclass Correlation ◽

Repeated Measurements ◽

Hand Injuries ◽

Force Measurements ◽

Pinch Force ◽

Experienced Examiner

Background and Purpose. There is limited documentation of measurement error of grip and pinch force evaluation methods. The purposes of this study were (1) to determine indexes of measurement error for intraexaminer and interexaminer measurements of grip and pinch force in patients with hand injuries and (2) to investigate whether the measurement error differs between measurements of the injured and noninjured hands and between experienced and inexperienced examiners. Subjects. The subjects were a consecutive sample of 33 patients with hand injuries who were seen in the Department of Rehabilitation Medicine of Erasmus MC–University Medical Center Rotterdam in the Netherlands. Methods. Repeated measurements were taken of grip and pinch force, with a short break of 2 to 3 minutes between sessions. For the grip force in 2 handle positions (distance between handles of 4.6 and 7.2 cm, respectively), tip pinch (with the index finger on top and the thumb below, with the other fingers flexed) and key pinch force (with the thumb on top and the radial side of the index finger below) data were obtained on both hands of the subjects by an experienced examiner and an inexperienced examiner. Intraclass correlation coefficients (ICCs), standard errors of measurement (SEMs), and associated smallest detectable differences (SDDs) were calculated and compared with data from previous studies. Results. The reliability of the measurements was expressed by ICCs between .82 and .97. For grip force measurements (in the second handle position) by the experienced examiner, an SDD of 61 N was found. For tip pinch and key pinch, these values were 12 N and 11 N, respectively. For measurements by the inexperienced examiner, SDDs of 56 N for grip force and 13 N and 18 N for tip pinch and key pinch were found. Discussion and Conclusion. Based on the SEMs and SDDs, in individual patients only relatively large differences in grip and pinch force measurements can be adequately detected between consecutive measurements. Measurement error did not differ between injured and noninjured hands or between experienced and inexperienced examiners. Criteria for judging whether the measurement error does allow application of the measurements in individual patients are discussed.

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Proximal Interphalangeal Arthrodesis in the Horse A Retrospective Study and a Modified Screw Technique

Veterinary Surgery ◽

10.1111/j.1532-950x.1990.tb01167.x ◽

1990 ◽

Vol 19 (3) ◽

pp. 196-202 ◽

Cited By ~ 33

Author(s):

J. P. CARON ◽

P. B. FRETZ ◽

J. V. BAILEY ◽

S. M. BARBER

Keyword(s):

Retrospective Study ◽

Interphalangeal Arthrodesis ◽

Proximal Interphalangeal Arthrodesis

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In VivoAnalysis of Trapeziometacarpal Joint Kinematics during Pinch Tasks

BioMed Research International ◽

10.1155/2014/157295 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8

Author(s):

Li-Chieh Kuo ◽

Chien-Ju Lin ◽

Guan-Po Chen ◽

I-Ming Jou ◽

Chien-Kuo Wang ◽

...

Keyword(s):

Computed Tomography ◽

3D Model ◽

Index Finger ◽

Reference Points ◽

Trapeziometacarpal Joint ◽

3D Images ◽

Distal Phalange ◽

Pinch Force ◽

Pip Joint

This study investigated how the posture of the thumb while performing common pinch movements and the levels of pinch force applied by the thumb affect the arthrokinematics of the trapeziometacarpal jointin vivo. Fifteen subjects performed the pinch tasks at the distal phalange (DP), proximal interphalangeal (PIP) joint, and metacarpophalangeal (MP) joint of the index finger with 0%, 50%, and 80% of maximal pinch forces by a single-axis load cell. 3D images of the thumb were obtained using the computed tomography. The results show that the reference points moved from the central region to the dorsal-radial region when changing from pinching the DP to the MP joint without pinching force being applied. Pinching with 80% of the maximum pinching force resulted in reference points being the closest to the volar-ulnar direction. Significant differences were seen between 0% and 50% of maximum pinch force, as well as between 0% and 80%, when pinching the MP joint in the distal-proximal direction. The effects of posture of the thumb and applied pinch force on the arthrokinematics of the joint were investigated with a 3D model of the trapeziometacarpal joint. Pinching with more than 50% of maximum pinch force might subject this joint to extreme displacement.

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The Effects of Joint Posture and Segment Lengths on the Thumb-Tip Force Produced by Flexor Pollicis Longus

ASME 2009 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2009-206258 ◽

2009 ◽

Author(s):

Craig M. Goehler ◽

Wendy M. Murray

Keyword(s):

Index Finger ◽

Hand Function ◽

Anatomical Study ◽

Flexor Pollicis Longus ◽

Lateral Aspect ◽

Biomechanical Models ◽

Pinch Force ◽

Data Support

The ability to hold an object between the thumb and the lateral aspect of the index finger (lateral pinch) is an important aspect of hand function. Previous studies suggest that current biomechanical models of the thumb do not accurately predict lateral pinch force [1, 2]. These studies modeled the thumb using simplified joint descriptions based on orthogonal and intersecting axes of rotation. A detailed anatomical study indicates that the axes of rotation of the thumb are actually both non-intersecting and non-orthogonal [3]. It has also been reported that the anatomical variability observed in the data support four different representations of thumb kinematics, all with non-intersecting and non-orthogonal axes [4].

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Proximal Interphalangeal Arthrodesis of Lesser Toes Utilizing K-Wires Versus Expanding Implants: Comparative Biomechanical Cadaveric Study

Foot & Ankle International ◽

10.1177/1071100718805066 ◽

2018 ◽

Vol 40 (2) ◽

pp. 231-236 ◽

Cited By ~ 2

Author(s):

Shane D. Rothermel ◽

Umur Aydogan ◽

Evan P. Roush ◽

Gregory S. Lewis

Keyword(s):

Cortical Bone ◽

Cadaver Study ◽

Initial Stiffness ◽

Fixation Devices ◽

Fusion Site ◽

Load To Failure ◽

Pip Joint ◽

Interphalangeal Arthrodesis ◽

K Wires ◽

Proximal Interphalangeal Arthrodesis

Background: Lesser toe proximal interphalangeal (PIP) joint arthrodesis is one of the most common foot and ankle elective procedures often using K-wires for fixation. K-wire associated complications led to development of intramedullary fixation devices. We hypothesized that X Fuse (Stryker) and Smart Toe (Stryker) would provide stronger and stiffer fixation than K-wire fixation. Methods: 12 cadaveric second toe pairs were used. In one group, K-wires stabilized 6 PIP joints, and 6 contralateral PIP joints were fixed with X Fuse. A second group used K-wires to stabilize 6 PIP joints, and 6 contralateral PIP joints were fixed with Smart Toe. Specimens were loaded cyclically with extension bending using 2-N step increases (10 cycles per step). Load to failure and initial stiffness were assessed. Statistical analysis used paired t tests. Results: K-wire average failure force, 91.0 N (SD 28.3), was significantly greater than X Fuse, 63.3 N (SD 12.9) ( P < .01). K-wire average failure force, 102.3 N (SD 17.7), was also significantly greater than Smart Toe, 53.3 N (SD 18.7) ( P < .01). K-wire initial stiffness 21.3 N/mm (SD 5.7) was greater than Smart Toe 14.4 N/mm (SD 9.3) ( P = .02). K-wire failure resulted from bending of K-wire or breaching cortical bone. X Fuse typically failed by implant pullout. Smart Toe failure resulted from breaching cortical bone. Conclusion: K-wires may provide stiffer and stronger constructs in extension bending than the X Fuse or Smart Toe system. This cadaver study assessed stability of the fusion site at time zero after surgery. Clinical Relevance: Our findings provide new data supporting biomechanical stability of K-wires for lesser toe PIP arthrodesis, at least in this clinically relevant mode of cyclic loading.

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