FUNCTIONAL AND KINEMATIC ANALYSIS OF A WRIST RADIAL HEMIARTHROPLASTY DESIGN

2018 ◽  
Vol 21 (01) ◽  
pp. 1850005
Author(s):  
Alexander W. Hooke ◽  
Eric Wagner ◽  
Kurt Pettersson ◽  
Per Fischer ◽  
Marco Rizzo
Keyword(s):  
Range Of Motion ◽  
Moment Arm ◽  
Ulnar Deviation ◽  
Functional Changes ◽  
Flexor Carpi Radialis ◽  
Moment Arms ◽  
Flexion Extension ◽  
Flexion Moment ◽  
The Mean ◽  
Extensor Carpi Radialis

Purpose: A biomechanical functional assessment was performed on a newly designed wrist hemiarthroplasty implant with aimed to identifying differences between the native wrist and wrist following the hemiarthroplasty procedure with [Formula: see text] and without a proximal row carpectomy (Hemi). Methods: Six cadaveric wrists were mounted on a custom testing fixture and underwent a series of functional tests to investigate differences in range of motion, muscles moment arms, and axis of rotation between the intact and post-operative wrists. The tested movements included manually-driven flexion-extension, radial-ulnar deviation, dart throwers motion, and circumduction. Results: The only significant change in range of motion was a decrease in flexion between the intact [Formula: see text] and both the Hemi [Formula: see text] and [Formula: see text] [Formula: see text] conditions. Minor differences in the mean position and variability of the axis of rotation’s piercing point were identified. A statistically significant decrease in the flexion moment arm of the flexor carpi radialis was identified between the intact ([Formula: see text][Formula: see text]mm) and [Formula: see text] ([Formula: see text][Formula: see text]mm) conditions. Statistically significant decreases were also identified in the radial deviation moment arms of the extensor carpi radialis brevis’ between the intact ([Formula: see text][Formula: see text]mm) and [Formula: see text] ([Formula: see text][Formula: see text]mm) conditions and the flexor carpi radialis’ between the intact ([Formula: see text][Formula: see text]mm) and Hemi ([Formula: see text][Formula: see text]mm) conditions as well as in the ulnar deviation moment arm of the extensor carpi ulnaris between the intact ([Formula: see text][Formula: see text]mm) and Hemi ([Formula: see text][Formula: see text]mm) conditions. Conclusions: While some statistically significant functional changes were identified between the native and hemiarthroplasty wrist, the findings suggest that post-operative function is equally acceptable in hemiarthroplasty with and without resection of the proximal carpal row.

Dynamic Effects of Muscle Moment Arm Variation and Heavy External Loads on Hinge Joints

2003 ◽  
Vol 19 (3) ◽  
pp. 223-238 ◽  
Author(s):  
Andrea Biscarini
Keyword(s):  
Angular Velocity ◽  
Range Of Motion ◽  
External Load ◽  
Joint Angle ◽  
Joint Modeling ◽  
Moment Arm ◽  
Moment Arms ◽  
Flexion Extension ◽  
External Loads ◽  
Load Weight

A two-dimensional model has been developed to predict and explain the effects of the variation of muscle moment arms during dynamic exercises involving heavy external loads. The analytical dependence of the muscle moment arm on the joint angle and on the origin and insertion position was derived for an ideal uniaxial hinge joint, modeling the muscle as a cable following an idealized minimum distance path from the origin to insertion that wraps around the bony geometry. Analytical expressions for the ratios of muscular force and the joint restraining reaction components to the external load weight were deduced, for isokinetic and static exercises, as a function of joint angle, joint angular velocity, and the other geometric parameters defining the model. Therefore, external load weight, joint angular velocity, and constraints to joint range of motion may be adjusted reciprocally in order to control in advance the peak value of the components of the joint load during isokinetic exercises. A dynamic formulation of forearm flexion/extension was solved numerically under the condition of constant biceps force in order to highlight the key role played by the variation in muscle moment arm in preventing injury during lifting of external loads against gravity. For example, our analysis indicates that the mean and peak resultant joint loads decrease by 5% and 14%, respectively, as a result of the change in muscle moment arm that occurs over the range of motion.

scholarly journals Functional and Structural Moment Arm Validation for Musculoskeletal Models: A Study of the Human Forearm and Hand

2020 ◽  
Author(s):  
Matthew T Boots ◽  
Russell Hardesty ◽  
Anton Sobinov ◽  
Valeriya Gritsenko ◽  
Jennifer L. Collinger ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Force Generation ◽  
High Dimensional ◽  
Artificial Limbs ◽  
Moment Arm ◽  
Joint Torques ◽  
Moment Arms ◽  
Physiological Range ◽  
Musculoskeletal Models ◽  
Flexion Extension

AbstractThe development of realistic musculoskeletal models is a fundamental goal for the theoretical progress in sensorimotor control and its engineering applications, e.g., in the biomimetic control of artificial limbs. Yet, accurate models require extensive experimental measures to validate structural and functional parameters describing muscle state over the full physiological range of motion. However, available experimental measurements of, for example, muscle moment arms are sparse and often disparate. Validation of these models is not trivial because of the highly complex anatomy and behavior of human limbs. In this study, we developed a method to validate and scale kinematic muscle parameters using posture-dependent moment arm profiles, isometric force measurements, and a computational detection of assembly errors. We used a previously published model with 18 degrees of freedom (DOFs) and 32 musculotendon actuators with force generated from a Hill-type muscle model. The muscle path from origin to insertion with wrapping geometry was used to model the muscle lengths and moment arms. We simulated moment arm profiles across the full physiological range of motion and compared them to an assembled dataset of published and merged experimental profiles. The muscle paths were adjusted using custom metrics based on root-mean-square and correlation coefficient of the difference between simulated and experimental values. Since the available measurements were sparse and the examination of high-dimensional muscles is challenging, we developed analyses to identify common failures, i.e., moment arm functional flipping due to the sign reversal in simulated moments and the imbalance of force generation between antagonistic groups in postural extremes. The validated model was used to evaluate the expected errors in torque generation with the assumption of constant instead of the posture-dependent moment arms at the wrist flexion-extension DOF, which is the critical joint in our model with the largest number of crossing muscles. We found that there was a reduction of joint torques by about 35% in the extreme quartiles of the wrist DOF. The use of realistic musculoskeletal models is essential for the reconstruction of hand dynamics. These models may improve the understanding of muscle actions and help in the design and control of artificial limbs in future applications.New & NoteworthyRealistic models of human limbs are a development goal required for the understanding of motor control and its applications in biomedical fields. However, developing accurate models is restrained by the lack of accurate and reliable musculoskeletal measurements in humans. Here, we have overcome this challenge by using multi-stage validation of simulated structures using both experimental data and the identification of structural failures in the high-dimensional muscle paths. We demonstrate that the rigorous structural and functional validation method is essential for the understanding of force generation at the wrist.

Analysis of the mero-carpopodite joint of the American lobster and snow crab. II. Kinematics, morphometrics and moment arms

2003 ◽  
Vol 83 (6) ◽  
pp. 1249-1259 ◽  
Author(s):  
S.C. Mitchell ◽  
M.E. DeMont
Keyword(s):  
Joint Angle ◽  
Snow Crab ◽  
Moment Arm ◽  
Scaling Effects ◽  
Joint Angles ◽  
Positive Allometry ◽  
Moment Arms ◽  
Arm Reaching ◽  
Flexion Extension ◽  
The Moment

This research reports on the kinematics of lobster and snow crab walking, documents changes in the moment arms of the mero-carpopodite joint during rotation, and examines scaling effects of morphological and mechanical variables in these crustacean species. Forward walking lobsters and lateral walking crabs were recorded and images analysed to describe the kinematics of these animals, and subsequently morphometric and moment arm measurements made. During forward walking the lobster maintains fixed mero-carpopodite joint angles during both the power and recovery strokes, though each of the walking legs maintains different joint angles. Legs 3 and 5 are maintained at angles which appear to equalize the flexor and extensor moment arms, and leg 4 joint angle appears to maximize the extensor moment arm. The snow crab has a joint excursion angle of between approximately 50° to 150° and, during flat bed walking, the leading and trailing legs move through similar excursion angles. The length of the meropodite for both species are longer for the anterior two leg pairs relative to the posterior two pairs and the rate of growth of the meropodite is largely isometric for the lobster while consistently increases with positive allometry in the crab. The flexor and extensor moment arms generated as the joint undergoes flexion/extension show two distinct patterns with the extensor moment arm being maximized at relatively low joint angles (55°–115°) and the flexor moment arm reaching a plateau at joint extension with angles between 95° and 155°. The flexor apodeme possesses the largest moment arms in all legs for both species, suggesting the flexors are able to generate greater torques. It appears that, mechanically, these laterally moving animals may be ‘pulling’ with the leading legs to a greater extent than ‘pushing’ with the trailing legs.

scholarly journals Impact of dynamic alignment, motion, and center of rotation on myelopathy grade and regional disability in cervical spondylotic myelopathy

2015 ◽  
Vol 23 (6) ◽  
pp. 690-700 ◽  
Author(s):  
Shian Liu ◽  
Renaud Lafage ◽  
Justin S. Smith ◽  
Themistocles S. Protopsaltis ◽  
Virginie C. Lafage ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Motion Analysis ◽  
Cervical Spondylotic Myelopathy ◽  
Dynamic Motion ◽  
Sf 36 ◽  
Flexion Extension ◽  
Focal Parameters ◽  
The Mean ◽  
Neck Disability ◽  
Flexion And Extension

OBJECT Cervical stenosis is a defining feature of cervical spondylotic myelopathy (CSM). Matsunaga et al. proposed that elements of stenosis are both static and dynamic, where the dynamic elements magnify the canal deformation of the static state. For the current study, the authors hypothesized that dynamic changes may be associated with myelopathy severity and neck disability. This goal of this study was to present novel methods of dynamic motion analysis in CSM. METHODS A post hoc analysis was performed of a prospective, multicenter database of patients with CSM from the AOSpine North American study. One hundred ten patients (34%) met inclusion criteria, which were symptomatic CSM, age over 18 years, baseline flexion/extension radiographs, and health-related quality of life (HRQOL) questionnaires (modified Japanese Orthopaedic Association [mJOA] score, Neck Disability Index [NDI], the 36-Item Short Form Health Survey Physical Component Score [SF-36 PCS], and Nurick grade). The mean age was 56.9 ± 12 years, and 42% of patients were women (n = 46). Correlations with HRQOL measures were analyzed for regional (cervical lordosis and cervical sagittal vertical axis) and focal parameters (kyphosis and spondylolisthesis between adjacent vertebrae) in flexion and extension. Baseline dynamic parameters (flexion/extension cone relative to a fixed C-7, center of rotation [COR], and range of motion arc relative to the COR) were also analyzed for correlations with HRQOL measures. RESULTS At baseline, the mean HRQOL measures demonstrated disability and the mean radiographic parameters demonstrated sagittal malalignment. Among regional parameters, there was a significant correlation between decreased neck flexion (increased C2–7 angle in flexion) and worse Nurick grade (R = 0.189, p = 0.048), with no significant correlations in extension. Focal parameters, including increased C-7 sagittal translation overT-1 (slip), were significantly correlated with greater myelopathy severity (mJOA score, Flexion R = −0.377, p = 0.003; mJOA score, Extension R = −0.261, p = 0.027). Sagittal slip at C-2 and C-4 also correlated with worse HRQOL measures. Reduced flexion/extension motion cones, a more posterior COR, and smaller range of motion correlated with worse general health SF-36 PCS and Nurick grade. CONCLUSIONS Dynamic motion analysis may play an important role in understanding CSM. Focal parameters demonstrated a significant correlation with worse HRQOL measures, especially increased C-7 sagittal slip in flexion and extension. Novel methods of motion analysis demonstrating reduced motion cones correlated with worse myelopathy grades. More posterior COR and smaller range of motion were both correlated with worse general health scores (SF-36 PCS and Nurick grade). To our knowledge, this is the first study to demonstrate correlation of dynamic motion and listhesis with disability and myelopathy in CSM.

The Effect of Radioscapholunate Fusion On Wrist Movement and the Subsequent Effects of Distal Scaphoidectomy and Triquetrectomy

2010 ◽  
Vol 35 (9) ◽  
pp. 740-745 ◽  
Author(s):  
M.J. Berkhout ◽  
M.N. Shaw ◽  
L.J. Berglund ◽  
K.N. An ◽  
R.A. Berger ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Surgical Techniques ◽  
Cadaver Study ◽  
Salvage Procedure ◽  
Ulnar Deviation ◽  
Radiocarpal Joint ◽  
Flexion Extension ◽  
Radioscapholunate Fusion ◽  
Tracking Device ◽  
Radioscapholunate Arthrodesis

Radioscapholunate arthrodesis is a salvage procedure indicated for osteoarthritis of the radiocarpal joint involving the lunate facet of the radius. This cadaver study examines changes in wrist motion resulting from radioscapholunate arthrodesis, and the effects of surgical techniques to improve the range of motion. Simulated radioscapholunate arthrodesis, distal scaphoidectomy and triquetrectomy were carried out sequentially on six cadaver forearms and measurements (maximum flexion/extension and radial/ulnar deviation) were taken in the intact situation and after each surgical step using a magnetic tracking device. Radioscapholunate arthrodesis diminishes the amplitudes of movements of the wrist in all directions, but range of motion in the radioscapholunate fused wrist improves after scaphoidectomy and improves further after triquetrectomy (88% of original flexion/extension and 98% of original radial/ulnar deviation). Radioscapholunate arthrodesis causes a significant change in kinematics between the hamate and the triquetrum in flexion/extension.

scholarly journals Radial Column Excision and Four-Corner Fusion for the Treatment of Basal Thumb Arthritis and Scapholunate Advanced Collapse Wrist or Midcarpal Arthritis

2017 ◽  
Vol 06 (04) ◽  
pp. 294-300 ◽  
Author(s):  
Avanthi Mandaleson ◽  
Michael Wagels ◽  
Stephen Tham
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Clinical Outcomes ◽  
Consecutive Series ◽  
Level Of Evidence ◽  
Ulnar Deviation ◽  
Pinch Grip ◽  
The Mean ◽  
Therapeutic Study

Background The combination of trapeziometacarpal arthritis and intercarpal pattern of degenerative wrist arthritis is uncommon. Purpose To report on the clinical and radiologic results of patients who have undergone radial column excision (scaphoidectomy and trapeziectomy) (RCE) and four-corner fusion (4CF). We describe the patterns of disease that present with basal thumb and midcarpal arthritis and treatment outcomes of a single-surgeon series. Patients and Methods A consecutive series of seven patients underwent RCE and 4CF over a 2-year period, for basal thumb osteoarthritis with concurrent degenerative midcarpal wrist arthritis. Six patients were available for review. All six patients were women with a mean age of 73 years (range: 67–78; SD 4.6). Mean follow-up time was 48.2 months (34–59 months). Radiographic and clinical outcomes were recorded for all patients, to include wrist range of motion, key pinch, grip strength, and patient-rated wrist evaluation (PRWE). Results There were no failures or revision procedures. The mean range of motion was flexion of 40 degrees (range: 30–40 degrees), extension of 30 degrees (range: 20–42 degrees), radial deviation of 18 degrees (range: 10–30 degrees), and ulnar deviation of 15 degrees (range: 0–25 degrees). The mean key pinch was 4.2 kg (range: 0.5–10, SD ± 3.5) and mean grip strength was 9.4 kg (range: 0–19, SD ± 8.9). The PRWE results in four patients were within normal values. Conclusion RCE with 4CF resulted in acceptable clinical outcomes in four of six patients treated, with no failures at a mean follow-up of 48.2 months. Level of Evidence Level IV, therapeutic study.

scholarly journals Clinical outcome of combined scaphocapitate fusion and posterior interosseous neurectomy for stage III Kienbock’s disease

2019 ◽  
Vol 5 (6) ◽  
pp. 1025
Author(s):  
Hossam Elden A. Abodonia ◽  
Mohammed H. Elbadawy ◽  
Ahmed A. Basha
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Positive Impact ◽  
Contralateral Side ◽  
Stage Iii ◽  
Kienböck’S Disease ◽  
Kienböck's Disease ◽  
Flexion Extension ◽  
The Mean ◽  
Kienbock’S Disease

<p class="abstract"><strong>Background:</strong> Treatment of Kienbock’s disease is still controversial. Several authors have described various surgical treatment options for Kienbock’s disease, all of whom reported successful treatment outcomes. The purpose of this study is to explore the clinical results of posterior interosseous neurectomy and scaphocapitate fusion as a treatment option for stage III Kienbock’s disease.</p><p class="abstract"><strong>Methods:</strong> This study evaluated the range of motion, grip and functional results after treatment of ten wrists of stage III Kienbock’s disease. Four males and six females with average age of 26.3 years, seven dominant and three non-dominant wrists were included. Two patients were smokers while six were housewives, three manual workers and a lawyer. The average follow up period was 14.2 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> Four patients revealed excellent, three good and three fair results. The mean modified Mayo score was 81.5. Flexion-extension range was 105.5° representing 74.9% of the contralateral side range. The mean flexion and extension range of operated side was increased, while the flexion increase was nonsignificant. Regarding radial-ulnar deviation, the mean range was 33.5° representing 76.5% of the contralateral side. The mean ulnar and radial deviation was increased, while the radial increase was nonsignificant. The mean grip strength was significantly increased to 90 mmHg representing 93.2% of the contralateral side.</p><p><strong>Conclusions:</strong> Scaphocpitate fusion is a recommended solution for treatment of late stages of Kienbock’s disease with lunate collapse. Longer postoperative time has a positive impact on grip strength and flexion-extension range of motion.</p>

scholarly journals A Comparative Study of Efficacy and Functionality of Ten Commercially Available Wrist-Hand Orthoses in Healthy Females: Wrist Range of Motion and Grip Strength Analysis

2021 ◽  
Vol 2 ◽  
Author(s):  
Alejandra Aranceta-Garza ◽  
Karyn Ross
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Evidence Base ◽  
Secondary Outcome ◽  
Functional Study ◽  
Strength Analysis ◽  
Hand Position ◽  
Ulnar Deviation ◽  
Flexion Extension ◽  
The Impact

Objective: Wrist-hand orthoses (WHOs) are prescribed for a range of musculoskeletal/neurological conditions to optimise wrist/hand position at rest and enhance performance by controlling its range of motion (ROM), improving alignment, reducing pain, and optimising grip strength. The objective of this research was to study the efficacy and functionality of ten commercially available WHOs on wrist ROM and grip strength.Design: Randomised comparative functional study of the wrist/hand with and without WHOs.Participants: Ten right-handed female participants presenting with no underlying condition nor pain affecting the wrist/hand which could influence motion or grip strength. Each participant randomly tested ten WHOs; one per week, for 10 weeks.Main outcome measures: The primary outcome was to ascertain the impact of WHOs on wrist resting position and flexion, extension, radial, and ulnar deviation. A secondary outcome was the impact of the WHOs on maximum grip strength and associated wrist position when this was attained.Results: From the 2,400 tests performed it was clear that no WHO performed effectively or consistently across participants. The optimally performing WHO for flexion control was #3 restricting 86.7%, #4 restricting 76.7% of extension, #9 restricting 83.5% of radial deviation, and #4 maximally restricting ulnar deviation. A grip strength reduction was observed with all WHOs, and ranged from 1.7% (#6) to 34.2% (#4).Conclusion: WHOs did not limit movement sufficiently to successfully manage any condition requiring motion restriction associated with pain relief. The array of motion control recorded might be a contributing factor for the current conflicting evidence of efficacy for WHOs. Any detrimental impact on grip strength will influence the types of activities undertaken by the wearer. The design aspects impacting wrist motion and grip strength are multifactorial, including: WHO geometry; the presence of a volar bar; material of construction; strap design; and quality of fit. This study raises questions regarding the efficacy of current designs of prefabricated WHOs which have remained unchanged for several decades but continue to be used globally without a robust evidence-base to inform clinical practise and the prescription of these devices. These findings justify the need to re-design WHOs with the goal of meeting users' needs.

MORPHOMETRIC AND BIOMECHANICAL COMPARISON OF TENDONS USED FOR INTERPOSITION ARTHROPLASTY IN CARPOMETACARPAL ARTHRITIS OF THE THUMB

Hand Surgery ◽  
2011 ◽  
Vol 16 (01) ◽  
pp. 43-47 ◽  
Author(s):  
Jens Dargel ◽  
Dietmar Pennig ◽  
Hans Philipp Springorum ◽  
Jürgen Koebke ◽  
Peer Eysel ◽  
...  
Keyword(s):  
Compressive Loading ◽  
Carpometacarpal Joint ◽  
Interposition Arthroplasty ◽  
Flexor Carpi Radialis ◽  
Abductor Pollicis Longus ◽  
Interpositional Arthroplasty ◽  
The Mean ◽  
Biomechanical Comparison ◽  
Extensor Carpi Radialis

Purpose: To identify the wrist tendon most effectively maintaining the trapezial space in interpositional arthroplasty in osteoarthritis of the carpometacarpal joint of the thumb. Methods: The morphometrics of the os trapezium and the tendons of the flexor carpi radialis, extensor carpi radialis longus, and abductor pollicis longus were determined. The stiffness and compressive loading characteristics of the rolled-up tendons were compared to the os trapezium. Results: No significant morphometric differences between the three tendons were found. The mass and volume of the trapezium was significantly larger when compared to the tendon balls. No significant differences in the compressive loading resistance were found between the tendons, but the mean stiffness was 85% lower when compared to the os trapezium. Conclusions: Neither tendon material approached the volume nor the stiffness provided by the os trapezium. Any tendon is considered to insufficiently maintain the trapezial space following trapeziectomy.

Effect of Wrist Posture on Discomfort for Simple Repetitive Exertions

2000 ◽  
Vol 44 (30) ◽  
pp. 5-473-5-476 ◽  
Author(s):  
Eilís J. Carey ◽  
Timothy J. Gallwey
Keyword(s):  
Range Of Motion ◽  
The Other ◽  
Maximum Strength ◽  
Angular Deviation ◽  
Ulnar Deviation ◽  
Flexion Extension ◽  
Male Subjects

This study investigated the effects of exertion, pace and level of simple and combined flexion/extension and radial/ulnar deviation of the wrist on discomfort for simple repetitive exertions. Eight male subjects participated in the study and the level of exertion and angular deviation were defined relative to the maximum strength and Range of Motion (ROM) of the subjects respectively. Extreme flexion caused higher discomfort than the other simple types of deviation, and the combination of flexion and ulnar deviation resulted in higher discomfort than the other types of combined deviation. Exertion was the most significant factor, followed by level of deviation.

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