Kinematics and Laxity of Ulnohumeral Joint Under Valgus-Varus Stress

1998 ◽  
Vol 02 (01) ◽  
pp. 45-54 ◽  
Author(s):  
Shinji Tanaka ◽  
Kai-Nan An ◽  
Bernard F. Morrey
Keyword(s):  
Elbow Joint ◽  
Three Dimensional ◽  
Elbow Flexion ◽  
Axial Rotation ◽  
Joint Laxity ◽  
Treatment Modalities ◽  
Trochlear Groove ◽  
Flexion Extension ◽  
Varus Stress ◽  
Baseline Information

Three-dimensional kinematics of the ulnohumeral joint under simulated active elbow joint flexion-extension was obtained by using an electromagnetic tacking device. The joint motion was analyzed based on Eulerian angle description. In order to minimize the effect of "downstream cross-talk" on calculation of the three Eulerian angles, an optimal axis to best represent flexion-extension of the elbow joint was established. This axis, on average, is close to the line joining the centers of the capitellum and the trochlear groove. Furthermore, joint laxity under valgus-varus stress was also examined. With the weight of the forearm as the stress, maximums of 7.6° valgus-varus laxity and 5.3° axial rotation laxity were observed within a range of elbow flexion. The results of this study provide useful baseline information on joint laxity for the evaluation of elbow joints with implant replacements and other surgical treatment modalities.

Proximal cueing to reduce elbow extension levels in suspect spin bowlers: A case study

2018 ◽  
Vol 13 (5) ◽  
pp. 643-648 ◽  
Author(s):  
Kane J Middleton ◽  
Denny JM Wells ◽  
Daryl H Foster ◽  
Jacqueline A Alderson
Keyword(s):  
Elbow Joint ◽  
Three Dimensional ◽  
Statistical Parametric Mapping ◽  
Elbow Flexion ◽  
Joint Kinematics ◽  
Hand Position ◽  
Elbow Extension ◽  
Waveform Data ◽  
Flexion Extension

Cricket bowlers must be able to deliver the ball with less than 15° of elbow extension or face suspension. The aim of this case study was to report the findings of a technique remediation programme on the elbow joint kinematics of an international cricket bowler. The bowler underwent a three-dimensional bowling analysis to measure his elbow joint kinematics before and after a technique remediation programme. The bowler was required to bowl six deliveries of each of his off-break, quicker and doosra variations. The remediation programme focussed on modifying the bowler’s run-up, shoulder alignment and ball/hand position at back foot impact. Elbow joint waveform data were analysed using statistical parametric mapping tests and coefficient of multiple determination. Elbow flexion–extension angles at discrete events were compared pre- and post-remediation using paired-sample t-tests. Results showed that the remediation programme was effective in reducing the amount of elbow flexion, particularly in the first 60% of the delivery cycle. Elbow extension range was significantly lower post-remediation for the off-break and quicker deliveries. It was concluded that basic short-term technique remediation can be effective in reducing elbow extension range.

Mechanical Evaluation of the Pronator Teres Rerouting Tendon Transfer

2004 ◽  
Vol 29 (3) ◽  
pp. 257-262 ◽  
Author(s):  
H. E. J. VEEGER ◽  
M. KREULEN ◽  
M. J. C. SMEULDERS
Keyword(s):  
Biceps Brachii ◽  
External Rotation ◽  
Three Dimensional ◽  
Muscle Length ◽  
Biomechanical Model ◽  
Elbow Flexion ◽  
Axial Rotation ◽  
Original Position ◽  
Pronator Quadratus ◽  
Pronator Teres

We simulated pronator teres rerouting using a three-dimensional biomechanical model of the arm. Simulations comprised the evaluation of changes in muscle length and the moment arm of pronator teres with changes in forearm axial rotation and elbow flexion. The rerouting of Pronator Teres was simulated by defining a path for it through the interosseous membrane with re-attachment to its original insertion. However the effect of moving the insertion to new positions, 2 cm below and above, the original position was also assessed. The effect on total internal rotation and external rotation capacity was determined by calculating the potential moments for pronator teres, supinator, pronator quadratus, biceps brachii and brachioradialis. Pronator teres was found to be a weak internal rotator in extreme pronation, but a strong internal rotator in neutral rotation and in supination. After rerouting pronator teres was only a strong external rotator in full pronation and not at other forearm positions, where the effect of rerouting was comparable to a release procedure.

scholarly journals Biomechanical Role and Motion Contribution of Ligaments and Bony Constraints in the Elbow Stability: A Preliminary Study

2019 ◽  
Vol 6 (3) ◽  
pp. 68 ◽  
Author(s):  
Elisa Panero ◽  
Laura Gastaldi ◽  
Mara Terzini ◽  
Cristina Bignardi ◽  
Arman Sard ◽  
...  
Keyword(s):  
Motion Capture ◽  
Elbow Joint ◽  
Large Deflection ◽  
Elbow Flexion ◽  
Elbow Instability ◽  
Joint Stability ◽  
Coronoid Fracture ◽  
Flexion Extension ◽  
Preliminary Study ◽  
Functional Investigation

In flexion–extension motion, the interaction of several ligaments and bones characterizes the elbow joint stability. The aim of this preliminary study was to quantify the relative motion of the ulna with respect to the humerus in two human upper limbs specimens and to investigate the constraints role for maintaining the elbow joint stability in different section conditions. Two clusters of four markers were fixed respectively to the ulna and humerus, and their trajectory was recorded by a motion capture system during functional orthopedic maneuver. Considering the posterior bundle of medial collateral complex (pMUCL) and the coronoid, two section sequences were executed. The orthopedic maneuver of compression, pronation and varus force was repeated at 30°, 60° and 90° flexion for the functional investigation of constraints. Ulna deflection was compared to a baseline elbow flexion condition. With respect to the intact elbow, the coronoid osteotomy influences the elbow stability at 90° (deflection = 11.49 ± 17.39 mm), while small differences occur at 30° and 60°, due to ligaments constraint. The contemporary pMUCL section and coronoid osteotomy causes elbow instability, with large deflection at 30° (deflection = 34.40 ± 9.10 mm), 60° (deflection = 45.41 ± 18.47 mm) and 90° (deflection = 52.16 ± 21.92 mm). Surgeons may consider the pMUCL reconstruction in case of unfixable coronoid fracture.

scholarly journals Biomechanical Analysis of Allograft Spacer Failure as a Function of Cortical-Cancellous Ratio in Anterior Cervical Discectomy/Fusion: Allograft Spacer Alone Model

2020 ◽  
Vol 10 (18) ◽  
pp. 6413
Author(s):  
Ji-Won Kwon ◽  
Hwan-Mo Lee ◽  
Tae-Hyun Park ◽  
Sung Jae Lee ◽  
Young-Woo Kwon ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Element Model ◽  
Axial Rotation ◽  
Biomechanical Analysis ◽  
Flexion Extension ◽  
Hybrid Motion ◽  
Anterior Cervical Discectomy Fusion ◽  
Flexion And Extension ◽  
Additional Fixation ◽  
Lateral Walls

The design and ratio of the cortico-cancellous composition of allograft spacers are associated with graft-related problems, including subsidence and allograft spacer failure. Methods: The study analyzed stress distribution and risk of subsidence according to three types (cortical only, cortical cancellous, cortical lateral walls with a cancellous center bone) and three lengths (11, 12, 14 mm) of allograft spacers under the condition of hybrid motion control, including flexion, extension, axial rotation, and lateral bending,. A detailed finite element model of a previously validated, three-dimensional, intact C3–7 segment, with C5–6 segmental fusion using allograft spacers without fixation, was used in the present study. Findings: Among the three types of cervical allograft spacers evaluated, cortical lateral walls with a cancellous center bone exhibited the highest stress on the cortical bone of spacers, as well as the endplate around the posterior margin of the spacers. The likelihood of allograft spacer failure was highest for 14 mm spacers composed of cortical lateral walls with a cancellous center bone upon flexion (PVMS, 270.0 MPa; 250.2%) and extension (PVMS: 371.40 MPa, 344.2%). The likelihood of allograft spacer subsidence was also highest for the same spacers upon flexion (PVMS, 4.58 MPa; 28.1%) and extension (PVMS: 12.71 MPa, 78.0%). Conclusion: Cervical spacers with a smaller cortical component and of longer length can be risk factors for allograft spacer failure and subsidence, especially in flexion and extension. However, further study of additional fixation methods, such as anterior plates/screws and posterior screws, in an actual clinical setting is necessary.

scholarly journals The 6-Plus–Person Lift Transfer Technique Compared With Other Methods of Spine Boarding

2008 ◽  
Vol 43 (1) ◽  
pp. 6-13 ◽  
Author(s):  
Gianluca Del Rossi ◽  
Mary Beth H. Horodyski ◽  
Bryan P. Conrad ◽  
Christian P. Di Paola ◽  
Matthew J. Di Paola ◽  
...  
Keyword(s):  
Spinal Injury ◽  
Three Dimensional ◽  
Axial Rotation ◽  
Linear Displacement ◽  
Angular Motion ◽  
Spinal Segment ◽  
Spinal Motion ◽  
Spinal Immobilization ◽  
Flexion Extension ◽  
Spine Board

Abstract Context: To achieve full spinal immobilization during on-the-field management of an actual or potential spinal injury, rescuers transfer and secure patients to a long spine board. Several techniques can be used to facilitate this patient transfer. Objective: To compare spinal segment motion of cadavers during the execution of the 6-plus–person (6+) lift, lift-and-slide (LS), and logroll (LR) spine-board transfer techniques. Design: Crossover study. Setting: Laboratory. Patients or Other Participants: Eight medical professionals (1 woman, 7 men) with 5 to 32 years of experience were enlisted to help carry out the transfer techniques. In addition, test conditions were performed on 5 fresh cadavers (3 males, 2 females) with a mean age of 86.2 ± 11.4 years. Main Outcomes Measure(s): Three-dimensional angular and linear motions initially were recorded during execution of transfer techniques, initially using cadavers with intact spines and then after C5-C6 spinal segment destabilization. The mean maximal linear displacement and angular motion obtained and calculated from the 3 trials for each test condition were included in the statistical analysis. Results: Flexion-extension angular motion, as well as anteroposterior and distraction-compression linear motion, did not vary between the LR and either the 6+ lift or LS. Compared with the execution of the 6+ lift and LS, the execution of the LR generated significantly more axial rotation (P  =  .008 and .001, respectively), more lateral flexion (P  =  .005 and .003, respectively), and more medial-lateral translation (P  =  .003 and .004, respectively). Conclusions: A small amount of spinal motion is inevitable when executing spine-board transfer techniques; however, the execution of the 6+ lift or LS appears to minimize the extent of motion generated across a globally unstable spinal segment.

FINITE ELEMENT MODELING OF HUMAN THORACIC SPINE

2004 ◽  
Vol 08 (04) ◽  
pp. 133-144 ◽  
Author(s):  
Tian-Xia Qiu ◽  
Ee-Chon Teo
Keyword(s):  
Finite Element ◽  
Thoracic Spine ◽  
Three Dimensional ◽  
Axial Rotation ◽  
Torsional Stiffness ◽  
Fe Model ◽  
Thoracic Vertebrae ◽  
Fundamental Information ◽  
Flexion Extension ◽  
Scoliosis Correction

Mathematical models, which can accurately represent the geometric, material and physical characteristics of the human spine structure, are useful in predicting biomechanical behaviors of the spine. In this study, a three-dimensional finite element (FE) model of thoracic spine (T1–T12) was developed, based on geometrical data of embalmed thoracic vertebrae (T1–T12) obtained from a precise flexible digitizer, and validated against published thoracolumbar experimental results in terms of the torsional stiffness of the whole thoracic spine (T1–T12) under axial torque alone and combined with distraction and compression loads. The torsional stiffness was increased by over 60% with application of a 425 N distraction force. A trend in increasing torsional stiffness with increasing distraction forces was detected. The validated model was then loaded under moment rotation in three anatomical planes to determine the ranges of motion (ROMs). The ROMs were approximately 37°, 31°, 32°, 51° for flexion, extension, lateral bending and axial rotation, respectively. These results may offer an insight to better understanding the kinematics of the human thoracic spine and provide clinically relevant fundamental information for the evaluation of spinal stability and instrumented devices functionality for optimal scoliosis correction.

A biomechanical comparison of three anterior thoracolumbar implants after corpectomy: are two screws better than one?

2006 ◽  
Vol 4 (3) ◽  
pp. 213-218 ◽  
Author(s):  
Dean Chou ◽  
Adolfo Espinoza Larios ◽  
Robert H. Chamberlain ◽  
Mary S. Fifield ◽  
Roger Hartl ◽  
...  
Keyword(s):  
Biomechanical Testing ◽  
Three Dimensional ◽  
Axial Rotation ◽  
Single Screw ◽  
Flexion Extension ◽  
Rod System ◽  
Mesh Cage ◽  
Left And Right ◽  
Plate System ◽  
Better Than

Object A flexibility experiment using human cadaveric thoracic spine specimens was performed to determine biomechanical differences among thoracolumbar two-screw plate, single-screw plate, and dual-rod systems. A secondary goal was to investigate differences in the ability of the systems to stabilize the spine after a one- or two-level corpectomy. Methods The authors evaluated 21 cadaveric spines implanted with a titanium mesh cage and three types of anterior thoracolumbar supplementary instrumentation after one-level thoracic corpectomies. Pure moments were applied quasistatically while three-dimensional motion was measured optoelectronically. The lax zone, stiff zone, and range of motion (ROM) were measured during flexion, extension, left and right lateral bending, and left and right axial rotation. Corpectomies were expanded to two levels, and testing was repeated with longer hardware. Biomechanical testing showed that the single-bolt plate system was no different from the dual-rod system with two screws in limiting ROM. The single-bolt plate system performed slightly better than the two-screw plate system. Across the same two levels, there was an average of 19% more motion after a two-level corpectomy than after a one-level corpectomy. In general, however, the difference across the different loading modes was insignificant. Conclusions Biomechanically, the single-screw plate system is equivalent to a two-screw dual-rod and a two-screw plate system. All three systems performed similarly in stabilizing the spine after one- or two-level corpectomies.

scholarly journals Finite element analysis of wedge and biconcave deformity in four different height restoration after augmentation of osteoporotic vertebral compression fracture

2020 ◽  
Author(s):  
Xiao-Hua Zuo ◽  
Ying-Bing Chen ◽  
Peng Xie ◽  
Wen-Dong Zhang ◽  
Xiang-Yun Xue ◽  
...  
Keyword(s):  
Finite Element ◽  
Three Dimensional ◽  
Axial Rotation ◽  
Neutral Position ◽  
Element Analysis ◽  
Flexion Extension ◽  
Dimensional Finite Element ◽  
Von Mises ◽  
Three Dimensional Finite Element ◽  
Wedge Fracture

Abstract Purpose Biomechanical comparison of wedge and biconcave deformity of different height restoration after augmentation of osteoporotic vertebral compression fractures was analyzed by three-dimensional finite element analysis (FEA). Methods Three-dimensional finite element model (FEM) of T11-L2 segment was constructed from CT scan of elderly osteoporosis patient. The von Mises stresses of vertebrae, intervertebral disc, facet joints, displacement, and range of motion (ROM) of wedge and biconcave deformity were compared at four different heights (Genant 0–3 grade) after T12 vertebral augmentation. Results In wedge deformity, the stress of T12 decreased as the vertebral height in neutral position, flexion, extension and left axial rotation, whereas increased sharply in bending at Genant 0; L1 and L2 decreased in all positions excluding flexion of L2, and T11 increased in neutral position, flexion, extension, and right axial rotation at Genant 0. No significant changes in biconcave deformity. The stress of T11-T12, T12-L1, and L1-L2 intervertebral disc gradually increased or decreased under other positions in wedge fracture, whereas L1-L2 no significant change in biconcave fracture. The utmost overall facet joint stress is at Genant 3, whereas there is no significant change under the same position in biconcave fracture. The displacement and ROM of the wedge fracture had ups and downs, while a decline in all positions excluding extension in biconcave fracture. Conclusions The vertebral restoration height after augmentation to Genant 0 affects the von Mises stress, displacement, and ROM in wedge deformity, which may increase the risk of fracture; Whereas restored or not in biconcave deformity.

scholarly journals Comparison of modelling and tracking methods for analysing elbow and forearm kinematics

2019 ◽  
Vol 233 (11) ◽  
pp. 1113-1121 ◽  
Author(s):  
Wei Wang ◽  
Dongmei Wang ◽  
Mariska Wesseling ◽  
Bin Xue ◽  
Feiyue Li
Keyword(s):  
Three Dimensional ◽  
Optimal Estimation ◽  
Elbow Flexion ◽  
Coordinate Systems ◽  
Kinematic Data ◽  
Measurement Protocol ◽  
Flexion Extension ◽  
Good Consistency ◽  
Optical Motion ◽  
Optical Motion Capture

This study aimed to find an optimal measurement protocol of elbow and forearm kinematics using different modelling and tracking methods. Kinematic data of elbow flexion/extension and forearm pronation/supination was acquired using optical motion capture from 12 healthy male volunteers. Segment coordinate systems for humerus, forearm, radius, ulna, and hand were defined. Different tracking methods, using anatomical markers or rigid or point maker clusters, were used to compute the three-dimensional rotations. Marker placement errors were assessed to evaluate the rigid body assumption. Multiple comparisons demonstrated statistical differences between tracking methods: compared to using only anatomical markers, tracking using clusters reduced the estimated range of pronation/supination by 14.9%–43.2%, while it estimated increased flexion/extension by 5.3%–9.1%. The study suggests using only anatomical markers exerts the optimal estimation of elbow and forearm kinematics. Modelling using the coordinate systems of the humerus and forearm and of the humerus and ulna, respectively, demonstrated good consistency with literature and are correspondingly regarded as the most appropriate approach for measuring pronation/supination and flexion/extension. The results are valuable in establishing a measurement protocol for analysing elbow and forearm kinematics, avoiding confusions and misinterpretations in communicating results from different methodologies.

scholarly journals Three-Dimensional Assessment of Upper Limb Proprioception via a Wearable Exoskeleton

2021 ◽  
Vol 11 (6) ◽  
pp. 2615
Author(s):  
Elisa Galofaro ◽  
Erika D’Antonio ◽  
Fabrizio Patané ◽  
Maura Casadio ◽  
Lorenzo Masia
Keyword(s):  
Neurological Diseases ◽  
Scientific Evidence ◽  
Three Dimensional ◽  
Sensory Information ◽  
Elbow Flexion ◽  
Muscle Spindles ◽  
Shoulder Abduction ◽  
Anatomical Location ◽  
Preferred Direction ◽  
Flexion Extension

Proprioception—the sense of body segment’s position and movement—plays a crucial role in human motor control, integrating the sensory information necessary for the correct execution of daily life activities. Despite scientific evidence recognizes that several neurological diseases hamper proprioceptive encoding with consequent inability to correctly perform movements, proprioceptive assessment in clinical settings is still limited to standard scales. Literature on physiology of upper limb’s proprioception is mainly focused on experimental approaches involving planar setups, while the present work provides a novel paradigm for assessing proprioception during single—and multi-joint matching tasks in a three-dimensional workspace. To such extent, a six-degrees of freedom exoskeleton, ALEx-RS (Arm Light Exoskeleton Rehab Station), was used to evaluate 18 healthy subjects’ abilities in matching proprioceptive targets during combined single and multi-joint arm’s movements: shoulder abduction/adduction, shoulder flexion/extension, and elbow flexion/extension. Results provided evidence that proprioceptive abilities depend on the number of joints simultaneously involved in the task and on their anatomical location, since muscle spindles work along their preferred direction, modulating the streaming of sensory information accordingly. These findings suggest solutions for clinical sensorimotor evaluation after neurological disease, where assessing proprioceptive deficits can improve the recovery path and complement the rehabilitation outcomes.

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