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 |
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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. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c547t-10415968e5587e3e20163d531c896fb78685e7e2235a9c6cbe39c72b848aa15a3</citedby><cites>FETCH-LOGICAL-c547t-10415968e5587e3e20163d531c896fb78685e7e2235a9c6cbe39c72b848aa15a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0363502315006024$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26163922$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Malone, Paul S.C., MBChB, PhD</creatorcontrib><creatorcontrib>Cooley, John, BS, MS</creatorcontrib><creatorcontrib>Terenghi, Giorgio, PhD</creatorcontrib><creatorcontrib>Lees, Vivien C., MB BChir, MD</creatorcontrib><title>The Effect of Elbow Extension on the Biomechanics of the Osseoligamentous Structures of the Forearm</title><title>The Journal of hand surgery (American ed.)</title><addtitle>J Hand Surg Am</addtitle><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.</description><subject>Biomechanical Phenomena</subject><subject>Cadaver</subject><subject>DRUJ</subject><subject>Elbow Joint - physiology</subject><subject>Equipment Design</subject><subject>Forearm - physiology</subject><subject>forearm biomechanics</subject><subject>Humans</subject><subject>IOL</subject><subject>Ligaments, Articular - physiology</subject><subject>Muscle, Skeletal - physiology</subject><subject>Orthopedics</subject><subject>Pronation</subject><subject>PRUJ</subject><subject>Supination</subject><issn>0363-5023</issn><issn>1531-6564</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUFr2zAUx8XoWNJsX6CH4mMvzp4kS7ahFNqQdoNADu3OQlaeF7m21Ur2tn77ySTNYYfBAwnx-z_e-4mQCwpLClR-bZbNPuglAyqWEIuyD2ROBaepFDI7I3PgkqcCGJ-R8xAagJji4hOZMRkvJWNzYp72mKzrGs2QuDpZt5X7naz_DNgH6_ok1hCBO-s6NHvdWxMmbHrbhoCutT91h_3gxpA8Dn40w-jxhNw7j9p3n8nHWrcBvxzPBflxv35afUs324fvq9tNakSWDymFjIpSFihEkSNHNk27i-uYopR1lReyEJgjY1zo0khTIS9NzqoiK7SmQvMFuTr0ffHudcQwqM4Gg22re4wDKppDQSVAJiPKDqjxLgSPtXrxttP-TVFQk1zVqEmumuQqiEVZDF0e-49Vh7tT5N1mBK4PAMYtf1n0KhiLvcGd9VGw2jn7__43_8RNa6Ny3T7jG4bGjb6P_hRVgSlQj9P3Tr9LBYAElvG_flee4g</recordid><startdate>20150901</startdate><enddate>20150901</enddate><creator>Malone, Paul S.C., MBChB, PhD</creator><creator>Cooley, John, BS, MS</creator><creator>Terenghi, Giorgio, PhD</creator><creator>Lees, Vivien C., MB BChir, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150901</creationdate><title>The Effect of Elbow Extension on the Biomechanics of the Osseoligamentous Structures of the Forearm</title><author>Malone, Paul S.C., MBChB, PhD ; Cooley, John, BS, MS ; Terenghi, Giorgio, PhD ; Lees, Vivien C., MB BChir, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c547t-10415968e5587e3e20163d531c896fb78685e7e2235a9c6cbe39c72b848aa15a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Biomechanical Phenomena</topic><topic>Cadaver</topic><topic>DRUJ</topic><topic>Elbow Joint - physiology</topic><topic>Equipment Design</topic><topic>Forearm - physiology</topic><topic>forearm biomechanics</topic><topic>Humans</topic><topic>IOL</topic><topic>Ligaments, Articular - physiology</topic><topic>Muscle, Skeletal - physiology</topic><topic>Orthopedics</topic><topic>Pronation</topic><topic>PRUJ</topic><topic>Supination</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Malone, Paul S.C., MBChB, PhD</creatorcontrib><creatorcontrib>Cooley, John, BS, MS</creatorcontrib><creatorcontrib>Terenghi, Giorgio, PhD</creatorcontrib><creatorcontrib>Lees, Vivien C., MB BChir, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of hand surgery (American ed.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Malone, Paul S.C., MBChB, PhD</au><au>Cooley, John, BS, MS</au><au>Terenghi, Giorgio, PhD</au><au>Lees, Vivien C., MB BChir, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Effect of Elbow Extension on the Biomechanics of the Osseoligamentous Structures of the Forearm</atitle><jtitle>The Journal of hand surgery (American ed.)</jtitle><addtitle>J Hand Surg Am</addtitle><date>2015-09-01</date><risdate>2015</risdate><volume>40</volume><issue>9</issue><spage>1776</spage><epage>1784</epage><pages>1776-1784</pages><issn>0363-5023</issn><eissn>1531-6564</eissn><abstract>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.</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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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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