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Biomechanical influences of pin placement and elbow angle on hinge alignment and joint distraction of bridged elbow-pin-fixator construct.

Abstract：

:Joint distraction and mobilization with a hinged external fixator preserves elbow stability and mobility. However, the alignment of both elbow and fixator hinges was the initial prerequisite of the arthrodiatasis technique. The main goal of this study was to numerically evaluate the kinematic influence of the device, surgery, and joint factors on hinge alignment. The kinetic effects of the pins placement and elbow angle on concentric distraction and mobilization were also discussed. A unilaterally hinged elbow-fixator system with a 14 links and 10 degrees-of-freedom was instrumented into a humeroulnar model. The Denavit-Hartenberg method with the homogeneous transformation matrixes was applied to perform kinematic analysis of the linkage system. The predicted results revealed that the concurrence of hinge alignment (i.e., kinematic) and concentric distraction (i.e., kinetic) necessitates two telescopic tubes orthogonal to the elbow hinge. The degrees-of-freedom arrangement of the fixator articulators plays a significant role in hinge alignment. After joint distraction, two hinges might be misaligned due to the difference in the structural rigidity of the pins, fixator, and stiffened elbow. Furthermore, those two prerequisite are interactive and sensitive to elbow angle, fixator design, and pin placement of the bridged elbow-pin-fixator construct. In addition, the ideally concentric distraction might occur only at an elbow angle of 120 degrees owing to the ulnar anatomy. Meticulous planning is necessary for such highly technically demanding surgery.

journal_name

J Biomech

journal_title

Journal of biomechanics

authors

Shih KS,Lin SC,Chao CK,Lee WS,Lu TW,Hou SM

doi

10.1016/j.jbiomech.2009.07.030

subject

Has Abstract

pub_date

2010-03-03 00:00:00

pages

757-63

issue

4

eissn

0021-9290

issn

1873-2380

pii

S0021-9290(09)00429-1

journal_volume

43

pub_type

杂志文章

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