The Effect of Elbow Extension on the Biomechanics of the Osseoligamentous Structures of the Forearm

Purpose To investigate the hypothesis that elbow extension alters the biomechanics of forearm rotation including force transmission in the distal and proximal radioulnar joints (DRUJ and PRUJ) and the interosseous ligament (IOL). Methods A cadaver model with a custom-designed jig was used to measure...

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Veröffentlicht in:The Journal of hand surgery (American ed.) 2015-09, Vol.40 (9), p.1776-1784
Hauptverfasser: Malone, Paul S.C., MBChB, PhD, Cooley, John, BS, MS, Terenghi, Giorgio, PhD, Lees, Vivien C., MB BChir, MD
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container_end_page 1784
container_issue 9
container_start_page 1776
container_title The Journal of hand surgery (American ed.)
container_volume 40
creator Malone, Paul S.C., MBChB, PhD
Cooley, John, BS, MS
Terenghi, Giorgio, PhD
Lees, Vivien C., MB BChir, MD
description Purpose To investigate the hypothesis that elbow extension alters the biomechanics of forearm rotation including force transmission in the distal and proximal radioulnar joints (DRUJ and PRUJ) and the interosseous ligament (IOL). Methods A cadaver model with a custom-designed jig was used to measure forearm pronosupination ranges, transmitted forces and contact areas across the PRUJ and DRUJ, and tension in the 3 main components of the IOL's central band. Testing with applied loads was undertaken throughout pronosupination with the elbow fully flexed (n = 15) and fully extended (n = 11). Results Elbow extension-flexion affected the range of forearm pronosupination, shifting the arc of rotation such that the forearm supinated maximally with the elbow flexed and pronated maximally with the elbow extended. Elbow extension also increased transmitted forces across the DRUJ and PRUJ while also increasing contact areas within the DRUJ and PRUJ. Elbow extension significantly increased tension in the central band of the IOL when the forearm was maximally pronated. Conclusions Maximum supination occurred with the elbow flexed. Maximum pronation occurred with it extended. Elbow position altered forearm biomechanics, including force transmission across the PRUJ and DRUJ and transmitted tension in the IOL. Clinical relevance The interplay of osseoligamentous forearm structures is such that we would anticipate surgical alteration of any one of them to have effects upon function of the others.
doi_str_mv 10.1016/j.jhsa.2015.05.012
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Methods A cadaver model with a custom-designed jig was used to measure forearm pronosupination ranges, transmitted forces and contact areas across the PRUJ and DRUJ, and tension in the 3 main components of the IOL's central band. Testing with applied loads was undertaken throughout pronosupination with the elbow fully flexed (n = 15) and fully extended (n = 11). Results Elbow extension-flexion affected the range of forearm pronosupination, shifting the arc of rotation such that the forearm supinated maximally with the elbow flexed and pronated maximally with the elbow extended. Elbow extension also increased transmitted forces across the DRUJ and PRUJ while also increasing contact areas within the DRUJ and PRUJ. Elbow extension significantly increased tension in the central band of the IOL when the forearm was maximally pronated. Conclusions Maximum supination occurred with the elbow flexed. Maximum pronation occurred with it extended. Elbow position altered forearm biomechanics, including force transmission across the PRUJ and DRUJ and transmitted tension in the IOL. Clinical relevance The interplay of osseoligamentous forearm structures is such that we would anticipate surgical alteration of any one of them to have effects upon function of the others.</description><identifier>ISSN: 0363-5023</identifier><identifier>EISSN: 1531-6564</identifier><identifier>DOI: 10.1016/j.jhsa.2015.05.012</identifier><identifier>PMID: 26163922</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Biomechanical Phenomena ; Cadaver ; DRUJ ; Elbow Joint - physiology ; Equipment Design ; Forearm - physiology ; forearm biomechanics ; Humans ; IOL ; Ligaments, Articular - physiology ; Muscle, Skeletal - physiology ; Orthopedics ; Pronation ; PRUJ ; Supination</subject><ispartof>The Journal of hand surgery (American ed.), 2015-09, Vol.40 (9), p.1776-1784</ispartof><rights>American Society for Surgery of the Hand</rights><rights>2015 American Society for Surgery of the Hand</rights><rights>Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. 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Methods A cadaver model with a custom-designed jig was used to measure forearm pronosupination ranges, transmitted forces and contact areas across the PRUJ and DRUJ, and tension in the 3 main components of the IOL's central band. Testing with applied loads was undertaken throughout pronosupination with the elbow fully flexed (n = 15) and fully extended (n = 11). Results Elbow extension-flexion affected the range of forearm pronosupination, shifting the arc of rotation such that the forearm supinated maximally with the elbow flexed and pronated maximally with the elbow extended. Elbow extension also increased transmitted forces across the DRUJ and PRUJ while also increasing contact areas within the DRUJ and PRUJ. Elbow extension significantly increased tension in the central band of the IOL when the forearm was maximally pronated. Conclusions Maximum supination occurred with the elbow flexed. Maximum pronation occurred with it extended. Elbow position altered forearm biomechanics, including force transmission across the PRUJ and DRUJ and transmitted tension in the IOL. 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Methods A cadaver model with a custom-designed jig was used to measure forearm pronosupination ranges, transmitted forces and contact areas across the PRUJ and DRUJ, and tension in the 3 main components of the IOL's central band. Testing with applied loads was undertaken throughout pronosupination with the elbow fully flexed (n = 15) and fully extended (n = 11). Results Elbow extension-flexion affected the range of forearm pronosupination, shifting the arc of rotation such that the forearm supinated maximally with the elbow flexed and pronated maximally with the elbow extended. Elbow extension also increased transmitted forces across the DRUJ and PRUJ while also increasing contact areas within the DRUJ and PRUJ. Elbow extension significantly increased tension in the central band of the IOL when the forearm was maximally pronated. Conclusions Maximum supination occurred with the elbow flexed. Maximum pronation occurred with it extended. Elbow position altered forearm biomechanics, including force transmission across the PRUJ and DRUJ and transmitted tension in the IOL. Clinical relevance The interplay of osseoligamentous forearm structures is such that we would anticipate surgical alteration of any one of them to have effects upon function of the others.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26163922</pmid><doi>10.1016/j.jhsa.2015.05.012</doi><tpages>9</tpages></addata></record>
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source MEDLINE; Elsevier ScienceDirect Journals
subjects Biomechanical Phenomena
Cadaver
DRUJ
Elbow Joint - physiology
Equipment Design
Forearm - physiology
forearm biomechanics
Humans
IOL
Ligaments, Articular - physiology
Muscle, Skeletal - physiology
Orthopedics
Pronation
PRUJ
Supination
title The Effect of Elbow Extension on the Biomechanics of the Osseoligamentous Structures of the Forearm
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