Pin Insertion to the Interosseous Hood Minimize the Finger Motion Restriction for the Proximal Phalangeal Percutaneous Fixation: A Cadaveric Study

2020 ◽  
Vol 25 (02) ◽  
pp. 177-183
Author(s):  
Akira Ikumi ◽  
Toshikazu Tanaka ◽  
Yusuke Matsuura ◽  
Kazuki Kuniyoshi ◽  
Takane Suzuki ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Insertion Point ◽  
Lateral Band ◽  
Significant Difference ◽  
Flexion Extension ◽  
Before And After ◽  
Pip Joint ◽  
Fresh Frozen ◽  
Joint Flexion ◽  
Finger Motion

Background: The purpose of this study was to identify the optimal pin insertion point to minimize finger motion restriction for proximal phalangeal fixation in cadaver models. Methods: We used 16 fingers from three fresh-frozen cadavers (age, 82–86 years). Each finger was dissected at the level of the carpometacarpal joint and fixated to a custom-built range of motion (ROM)-measuring apparatus after skin removal. The pin was inserted into the bone through four gliding soft tissues: the interosseous hood, dorsal capsule, lateral band, and sagittal band. Then, each tendon was pulled by a prescribed weight in three finger positions (flexion, extension, and intrinsic plus position). Changes in the metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) angles were measured before and after pinning. We compared the differences between the insertion points using the Tukey-Kramer post hoc test. Results: Placement of pins into the sagittal band significantly restricted MCP joint flexion, while placement into the dorsal capsule and lateral band significantly restricted PIP joint flexion. Only placement into the interosseous hood showed no significant difference in joint angles between the three finger positions compared to pre-pin insertion. There were no significant effects on MCP, PIP, and DIP joint extension. Conclusions: The ROM of the MCP joint was obstructed due to pinning in most areas of insertion. However, pin insertion to the interosseous hood did not obstruct the finger flexion ROM compared to that of other gliding soft tissues; therefore, we believe that the interosseous hood may be a suitable pin insertion point for proximal phalangeal fixation.

Quantitative Analysis of the Linkage between the interphalangeal Joints of the Index Finger

1995 ◽  
Vol 20 (5) ◽  
pp. 696-699 ◽  
Author(s):  
P. HAHN ◽  
H. KRIMMER ◽  
A. HRADETZKY ◽  
U. LANZ
Keyword(s):  
System Analysis ◽  
Measuring System ◽  
Dominant Hand ◽  
Rectangular Coordinate System ◽  
Simple Method ◽  
Significant Difference ◽  
Pip Joint ◽  
Distal Interphalangeal ◽  
Joint Flexion ◽  
Opening And Closing

We have established a simple method of measuring joint motion under physiological conditions. For this purpose we use an ultrasound measuring system employing marker points consisting of miniaturized ultrasound transmitters. This device was tested on a simple biomeehanical model, the linkage of the proximal and distal interphalangeal joints. The angles of these joints were recorded during opening and closing of the fist in 34 index fingers of 17 healthy persons. The results of the measurements were plotted on a rectangular coordinate system. Analysis showed an approximately linear linkage between the IP joints of the index linger. The curve for extension was the same as that for flexion. The linkage varies greatly. On average 1° of PIP joint flexion is equivalent to 0.76° of DIP joint flexion. Our study showed no significant difference between the dominant and non-dominant hand. The results showed that there is a linear linkage between the proximal and distal interphalangeal joints, which is equal for flexion and extension.

scholarly journals Static Balancing Ability and Lower Body Kinematics Examination of Hungarian Folk Dancers: A Pilot Study Investigating the “Kalocsai Mars” Dance Sequence

2021 ◽  
Vol 11 (18) ◽  
pp. 8789
Author(s):  
Cecília Molnár ◽  
Zsófia Pálya ◽  
Rita M. Kiss
Keyword(s):  
Measurement Procedure ◽  
Folk Dance ◽  
Lower Body ◽  
Dance Movement ◽  
Static Balancing ◽  
Flexion Extension ◽  
Before And After ◽  
Posterior Direction ◽  
Joint Flexion ◽  
Hip Flexion

Folk dance is a collection of traditional dances that requires years of practicing to perform correctly. The aim of the present study was to develop a complex biomechanical measurement procedure that investigated Hungarian folk dancers’ balancing ability and lower body kinematics through a dance movement called “Kalocsai mars”. Therefore, 11 dancers’ motion (5 female and 6 male; age: 20.5 ± 2.5 years; height: 173.82 ± 7.82 cm; weight: 64.77 ± 8.67 kg) was recorded with an optical-based motion capture system and force platforms simultaneously. Before and after the dancing session, static balancing tests were performed, examining bipedal stance with eyes opened and closed conditions. The ANOVA results showed that the values of the range of motions of the knee joint flexion-extension angles and hip flexion averaged for sessions increased significantly (p=0.044, p=0.003, p=0.005) during the dancing sessions. The deviation in the joint angle was greater in the nondominant legs, suggesting that the nondominant side requires more attention to execute the dance steps correctly. The results of the balance tests showed that the oscillation in the posterior direction increased significantly after dancing (p=0.023). In comparison, the visual feedback had no significant effect on the dancers’ balancing ability.

Tracking Translations in the Human Hip

2012 ◽  
Author(s):  
Sima Zakani ◽  
Erin J. Smith ◽  
Manuela Kunz ◽  
Gavin C. A. Wood ◽  
John Rudan ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Femoral Head ◽  
Soft Tissues ◽  
Surgical Navigation ◽  
Ex Vivo ◽  
Acetabular Cup ◽  
Hip Morphology ◽  
Flexion Extension ◽  
Hip Motion ◽  
Fresh Frozen

Translations of the femoral head with respect to the acetabular cup, in non-impinging zones, was investigated using surgical navigation methods. An ex-vivo study was conducted on five fresh-frozen human cadaver pelvises in distinct dissection states. Each specimen underwent a series of motions that included combinations of abduction/adduction, flexion/extension and internal/external rotations, repeated in four soft-tissue states: soft tissues intact; partially dissected with capsule intact; Z-shaped capsulotomy; and fully dissected and disarticulated. The data showed significant increases of excursions (p<0.05) between the first three soft tissue states. The findings supported the recently proposed model of aspherical hip motion, and imply that the femoral head translated before and after impingement. The results bring into question many accepted ideas in hip morphology, kinematics and surgical planning.

scholarly journals KOMBINASI MCKENZIE EXERCISE DAN ULTRASOUND LEBIH BAIK DARIPADA MYOFASCIAL RELEASE DAN ULTRASOUND UNTUK MEMPERBAIKI DISABILITAS PADA MECHANICAL NECK PAIN

2017 ◽  
Author(s):  
Jasmine Kartiko Pertiwi ◽  
Ketut Tirtayasa ◽  
Sugijanto ◽  
J. Alex. Pangkahila ◽  
I Made Muliarta ◽  
...  
Keyword(s):  
Neck Pain ◽  
Soft Tissues ◽  
Joint Space ◽  
T Test ◽  
Mean Difference ◽  
Myofascial Release ◽  
Group I ◽  
Significant Difference ◽  
Before And After ◽  
Quasi Experimental

Introdaction: Patients with mechanic neck pain a population that often found overstretches it is caused by occurred between the two bones in the neck on the ligaments and soft tissues located around, static resulting in hipomibilitas the joint space and joint play movement, resulting in the emergence of provocation on the part of the occipital region on Cervical stressor resulting in excess tissue around the contractile and non-contractile. Purpose: This study the application of ultrasound and McKenzie exercise and myofacial release ultrasound in reducing disability in mechanical neck pain, Methods: This research method is a quasi experimental research with Pre and Post Test Two Group Design. The samples were divided into two treatment groups consisting of McKenzie exercice and ultrasounds were 20 participants with myofascial release and ultrasound with 19 participants, a total of 39 participants. Result: Differences between the mean decrease in neck with NDI disability before and after the application of each group were tested by t-test related, the results obtained mean between the groups before treatment 17,10±1,889% and after treatment 12,90±2,490% by value (p = 0.001) with a mean difference of 42% and showed the average group between before treatment 17,42±2,388% and after treatment 15,63±2,362% (p = 0.001) with a mean difference of 17,9%. The statistical test of using independent t-test showed is a significant difference between group I and group II and the result is p = 0.001 (p< 0.05). Conclusion: application of combined Mc Kenzie exercise and ultrasound better than the application of a combination of myofacial release and ultrasound in reducing disabilities in case of mechanical neck pain.

scholarly journals The Effect of an Open Carpal Tunnel Release on Thumb CMC Biomechanics

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Marc A. Tanner ◽  
Bryan P. Conrad ◽  
Paul C. Dell ◽  
Thomas W. Wright
Keyword(s):  
Carpal Tunnel ◽  
Soft Tissues ◽  
Carpal Tunnel Release ◽  
Transverse Carpal Ligament ◽  
Before And After ◽  
Fresh Frozen ◽  
Rigid Body Mechanics ◽  
Thumb Carpometacarpal ◽  
Open Carpal Tunnel Release ◽  
Cmc Joint

Purpose. We have observed worsening thumb pain following carpal tunnel release (CTR) in some patients. Our purpose was to determine the effect of open CTR on thumb carpometacarpal (CMC) biomechanics.Methods. Five fresh-frozen cadaver arms with intact soft tissues were used. Each specimen was secured to a jig which fixed the forearm at 45° supination, and the wrist at 20° dorsiflexion, with thumb pointing up. The thumb was axially loaded with a force of 130 N. We measured 3D translation and rotation of the trapezium, radius, and first metacarpal, before and after open CTR. Motion between radius and first metacarpal, radius and trapezium, and first metacarpal and trapezium during loading was calculated using rigid body mechanics. Overall stiffness of each specimen was determined.Results. Total construct stiffness following CTR was reduced in all specimens but not significantly. No significant changes were found in adduction, pronation, or dorsiflexion of the trapezium with respect to radius after open CTR. Motion between radius and first metacarpal, between radius and trapezium, or between first metacarpal and trapezium after open CTR was not decreased significantly.Conclusion. From this data, we cannot determine if releasing the transverse carpal ligament alters kinematics of the CMC joint.

Pyrocardan Scaphotrapeziotrapezoid Joint Arthroplasty for Isolated Osteoarthritis: Results after a Mean Follow-Up of 5 Years

2021 ◽  
Author(s):  
Martin Cholley-Roulleau ◽  
Yves Bouju ◽  
Flore-Anne Lecoq ◽  
Alexandre Fournier ◽  
Philippe Bellemère
Keyword(s):  
Case Series ◽  
Preoperative Assessment ◽  
Contralateral Side ◽  
High Rate ◽  
Significant Difference ◽  
Flexion Extension ◽  
Functional Scores ◽  
Before And After ◽  
The Mean

Abstract Background Isolated scaphotrapeziotrapezoid (STT) osteoarthritis (OA) mainly develops in women over 50 years of age in a bilateral manner. Many surgical treatments are available, including distal scaphoid resection with or without interposition, trapeziectomy, and STT arthrodesis. However, there is a controversy about which procedure is the most effective. Purposes The purpose of this study was to report the outcomes of the Pyrocardan implant for treating STT isolated OA at a mean follow-up of 5 years. Patients and Methods Consecutive patients who underwent STT arthroplasty using the Pyrocardan were reviewed retrospectively by an independent examiner who performed a clinical and radiological evaluation. Results The mean follow-up time was 5 years (range 3–8 years). Thirteen patients (76%) were followed for more than 5 years. Between the preoperative assessment and the last follow-up, pain levels decreased significantly. There was no significant difference in the mean Kapandji opposition score. Grip and pinch strengths were 88 and 91% of the contralateral side. The active range of motion in flexion–extension and radioulnar deviation was not significantly different to the contralateral side (119° vs. 121° and 58° vs. 52°, p > 0.1). Functional scores were improved significantly. No identifiable differences were found in the radioscaphoid, capitolunate, and scapholunate angles before and after surgery. In three cases, the preoperative dorsal intercalated scapholunate instability (DISI) failed to be corrected. In one case, DISI appeared after the procedure. There was one asymptomatic dislocation of the implant. Calcification around the trapezium and/or distal scaphoid was found in four cases. The survival rate of the implant without reoperation was 95%. Conclusions In the medium term, Pyrocardan implant is an effective treatment for STT OA as it reduces pain, increases grip strength, and maintains wrist mobility. This is consistent with the results of other published case series using pyrocarbon implants. It provides a high rate of patient satisfaction. Nevertheless, the surgical procedure must be done carefully to avoid STT ligament damage, periarticular calcifications, or dislocation.

Biomechanical evaluation of destabilization following minimally invasive decompression for lumbar spinal canal stenosis

2013 ◽  
Vol 18 (5) ◽  
pp. 504-510 ◽  
Author(s):  
Kazuhiro Hasegawa ◽  
Ko Kitahara ◽  
Haruka Shimoda ◽  
Toshiaki Hara
Keyword(s):  
Ex Vivo ◽  
Biomechanical Study ◽  
Neutral Zone ◽  
Posterior Decompression ◽  
Intact Specimen ◽  
Canal Stenosis ◽  
Significant Difference ◽  
Flexion Extension ◽  
Fresh Frozen ◽  
Loading Modes

Object This study aimed to clarify changes in segmental instability following a unilateral approach for microendoscopic posterior decompression and muscle-preserving interlaminar decompression compared with traditional procedures and destabilized models. Methods An ex vivo experiment was performed using 30 fresh frozen porcine functional spinal units (FSUs). Each intact specimen was initially tested for flexion-extension, lateral bending, and torsion up to 1.5° using a material testing system at an angular velocity of 0.1°/second under a preload of 70 N. Microendoscopic posterior decompression, muscle-preserving interlaminar decompression, bilateral medial facetectomy, left unilateral total facetectomy, and bilateral total facetectomy were then performed, followed by mechanical testing with the same loading conditions, in 6 randomized FSUs from each group. Stiffness and neutral zone were standardized by dividing the experimental values by the baseline values and were then compared among groups. Results Mean standardized stiffness values for all loading modes tended to decrease in the order of muscle-preserving interlaminar decompression, microendoscopic posterior decompression, bilateral medial facetectomy, left unilateral total facetectomy, and bilateral total facetectomy. In contrast, mean standardized neutral zone values tended to increase in the order of muscle-preserving interlaminar decompression, microendoscopic posterior decompression, bilateral medial facetectomy, left unilateral total facetectomy, and bilateral total facetectomy. In flexion, values for standardized stiffness following microendoscopic posterior decompression and muscle-preserving interlaminar decompression were higher and standardized neutral zone following microendoscopic posterior decompression and muscle-preserving interlaminar decompression were lower than the values following left unilateral total facetectomy and bilateral total facetectomy while there was no significant difference among bilateral medial facetectomy, left unilateral total facetectomy, and bilateral total facetectomy. Values of standardized stiffness and standardized neutral zone in left torsion following microendoscopic posterior decompression, muscle-preserving interlaminar decompression, and bilateral medial facetectomy were equally superior to values of the destabilization models (left unilateral total facetectomy and bilateral total facetectomy). Except for standardized stiffness in left bending, the values of the parameters for each bending tended to be the same as in the other loading modes. Conclusions The present biomechanical study showed that overall stability of the FSUs was maintained following microendoscopic posterior decompression, muscle-preserving interlaminar decompression, and bilateral medial facetectomy compared with the destabilization models of left unilateral total facetectomy or bilateral total facetectomy. Comparison of the postoperative stability following microendoscopic posterior decompression, muscle-preserving interlaminar decompression, and bilateral medial facetectomy revealed that muscle-preserving interlaminar decompression tended to be superior, followed by microendoscopic posterior decompression and bilateral medial facetectomy.

Repair of pars interarticularis defect utilizing a pedicle and laminar screw construct: a new technique based on anatomical and biomechanical analysis

2012 ◽  
Vol 17 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Rakesh D. Patel ◽  
Humberto G. Rosas ◽  
Michael P. Steinmetz ◽  
Paul A. Anderson
Keyword(s):  
Pedicle Screw ◽  
Spinal Canal ◽  
Biomechanical Analysis ◽  
Laminar Screw ◽  
Functional Spinal Unit ◽  
Significant Difference ◽  
Flexion Extension ◽  
Pars Interarticularis ◽  
Before And After ◽  
Biomechanical Tests

Object The theoretical advantage of pars interarticularis repair over spinal fusion to correct pars defects is that the treatment is a direct osteosynthesis that preserves motion at the involved functional spinal unit. Several techniques and constructs have been used to achieve greater rigidity, but these techniques may risk entry into the spinal canal, and adverse events are common. A pedicle and laminar screw construct placed entirely outside the spinal canal may offer greater stiffness and achieve higher pars defect healing rates. The purpose of this study was to biomechanically assess an intralaminar screw construct in cadaveric lumbar spines in comparison with other types of constructs typically used in pars repair and to quantify the sizes of screws that can be placed safely in both normal and spondylolytic vertebrae. Methods The L-4 and L-5 laminae in patients with spondylolysis and in controls who underwent CT (n = 41, each group) were measured by analysis of conventional axial CT images and multiplanar reformations constructed on a Vitrea workstation to determine the feasibility of translaminar fixation with a 4.5-mm-diameter screw. Biomechanical tests for torsion and flexion-extension were performed on 8 fresh human cadaveric lumbar spines before and after modeling for bilateral spondylolytic defects. Three pars repair techniques were tested at each level and in the following sequence: pedicle screw–cable, pedicle screw–rod–hook, and pedicle screw–intralaminar screw. Results The majority of laminae can accept 4.5 × 25-mm screws. The cable construct allowed the greatest motion and least stability across the defect in all biomechanical tests. The hook and laminar screw constructs performed similarly in all tests and exhibited no significant difference in stiffness. Conclusions A surgically placed intralaminar screw construct may be a safe and effective alternative to current pars repair methods.

scholarly journals Effect of McGlamry Elevator Placement on the Plantar Plate Origin

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0045
Author(s):  
Natalie Singer ◽  
Fred Finney ◽  
Paul Talusan
Keyword(s):  
Soft Tissues ◽  
Surgical Techniques ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Dorsal Approach ◽  
Deep Placement ◽  
Plantar Plate ◽  
Significant Difference ◽  
Fresh Frozen ◽  
Relationship Of

Category: Lesser Toes Introduction/Purpose: Lesser metatarsal phalangeal (MTP) joint plantar plate tears have been implicated in a variety of lesser toe pathologies, and plantar plate repair (PPR) through a dorsal approach has become increasingly popular as a treatment of lesser toe deformities and lesser MTP instability. With the aid of a McGlamry elevator, releasing the collateral ligaments and micro-suture passing techniques, the plantar plate is repaired under direct visualization. While this approach is seen as a reliable alternative, the consequence of this technique on local MTP joint anatomy is not yet well understood. The purpose of this study is to describe the proximal plantar plate attachment and to quantify the amount of soft tissue disruption of the lesser toe MTP joint anatomy with insertion of a McGlamry elevator. Methods: Fresh frozen human cadaveric feet were dissected, and the proximal plantar plate attachment of the second, third, and fourth toe MTP joints (n=6) were examined, focusing on the relationship of structures connecting the distal metatarsal shaft and head to the plantar plate. The accessory collateral ligament insertions and proximal plantar plate attachments were measured using digital calipers. Next, the second, third, and fourth rays (n=12) of separate fresh frozen cadaveric specimens were isolated. An 11mm McGlamry elevator was then inserted in standard surgical fashion in both a more shallow (limited exposure) and deeper (greater exposure) position. Using mini C-arm fluoroscopy, radiographs were taken in both positions, and the depth of insertion along the metatarsal was measured. Results: The proximal plantar plate attachment to the metatarsal is most robust just proximal to the lateral articular margin and this attachment extends an average of 10.42mm (SD= 2.71mm) proximally along the metatarsal neck and shaft. In addition there are stout proximal plantar plate attachments at the bilateral insertion sites of the accessory collateral ligament (ACL) which are thick and broad with an average insertion length of 9.01mm (SD=1.35mm). Insertion of a McGlamry elevator resulted in stripping of the distal plantar soft tissues over an average of 21.58% of the total metatarsal length (SD=4.43%) for shallow placement and 34.87% (SD=4.40%) for deep placement with a significant difference of 7.96% between the two positions (p<.00001). Conclusion: Current techniques of plantar plate repair through a dorsal approach require releasing collateral ligaments and proximal stripping of the plantar plate from the metatarsal for adequate visualization. We suggest that this significantly destabilizes the metatarsal from the plantar plate as it strips approximately the distal most one third of the metatarsal including all major proximal plantar plate attachments to the metatarsal. As surgical techniques continue to evolve and improve, surgeons should consider avoiding the placement of a McGlamry elevator as this can destabilize the proximal attachment of the plantar plate to the metatarsal.

Comparison of the biomechanics of hydroxyapatite and polymethylmethacrylate vertebroplasty in a cadaveric spinal compression fracture model

2001 ◽  
Vol 95 (2) ◽  
pp. 215-220 ◽  
Author(s):  
Patrick W. Hitchon ◽  
Vijay Goel ◽  
John Drake ◽  
Derek Taggard ◽  
Matthew Brenton ◽  
...  
Keyword(s):  
Compression Fracture ◽  
Axial Rotation ◽  
Load Testing ◽  
Lateral Bending ◽  
Content Type ◽  
Significant Difference ◽  
Flexion Extension ◽  
Before And After ◽  
Weight Drop ◽  
Fine Print

Object. Polymethylmethacrylate (PMMA) has long been used in the stabilization and reconstruction of traumatic and pathological fractures of the spine. Recently, hydroxyapatite (HA), an osteoconductive, biocompatible cement, has been used as an alternative to PMMA. In this study the authors compare the stabilizing effects of the HA product, BoneSource, with PMMA in an experimental compression fracture of L-1. Methods. Twenty T9—L3 cadaveric spine specimens were mounted individually on a testing frame. Light-emitting diodes were placed on the neural arches as well as the base. Motion was tracked by two video cameras in response to applied loads of 0 to 6 Nm. The weight-drop technique was used to induce a reproducible compression fracture of T-11 after partially coring out the vertebra. Load testing was performed on the intact spine, postfracture, after unilateral transpedicular vertebroplasty with 7 to 10 ml of PMMA or HA, and after flexion—extension fatiguing to 5000 cycles at ± 3 Nm. No significant difference between the HA- and PMMA cemented—fixated spines was demonstrated in flexion, extension, left lateral bending, or right and left axial rotation. The only difference between the two cements was encountered before and after fatiguing in right lateral bending (p ≤ 0.05). Conclusions. The results of this study suggest that the same angular rigidity can be achieved using either HA or PMMA. This is of particular interest because HA is osteoconductive, undergoes remodeling, and is not exothermic.

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