Changes in elbow joint contact area in symptomatic valgus instability of the elbow in baseball players

Numaguchi, Kyosuke; Momma, Daisuke; Matsui, Yoshihiko; Oohinata, Jun; Yamaguchi, Takayoshi; Inoue, Nozomu; Kondo, Eiji; Iwasaki, Norimasa

doi:10.1038/s41598-021-99193-0

Cited by 5 publications

(4 citation statements)

References 27 publications

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“…RNFs, among the most common elbow fractures, typically result from falls on an outstretched arm 32 . Stabilizing the radial head post-fracture is crucial, as it resists valgus stress, serves as a weight-bearing structure in axial orientation, and contributes to elbow stability [3][4][5][6][7] . Excessive force application during the early stages of fracture healing may lead to fixation failure, with axial force generated during daily forearm pronation activities, and bending and torsional forces simulating shear forces applied by the ulna to the radial head 13,20,21 .…”

Section: Discussionmentioning

confidence: 99%

Is implant choice associated with fixation strength for displaced radial neck fracture: a network meta-analysis of biomechanical studies

Su¹,

Wang²,

Fang³

et al. 2023

Sci Rep

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The multitude of fixation options for radial neck fractures, such as pins, screws, biodegradable pins and screws, locking plates, and blade plates, has led to a lack of consensus on the optimal implant choice and associated biomechanical properties. This study aims to evaluate the biomechanical strength of various fixation constructs in axial, sagittal, and torsional loading directions. We included biomechanical studies comparing different interventions, such as cross/parallel screws, nonlocking plates with or without augmented screws, fixed angle devices (T or anatomic locking plates or blade plates), and cross pins. A systematic search of MEDLINE (Ovid), Embase, Scopus, and CINAHL EBSCO databases was conducted on September 26th, 2022. Data extraction was carried out by one author and verified by another. A network meta-analysis (NMA) was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Primary outcomes encompassed axial, bending, and torsional stiffness, while the secondary outcome was bending load to failure. Effect sizes were calculated for continuous outcomes, and relative treatment ranking was measured using the surface under the cumulative ranking curve (SUCRA). Our analysis encompassed eight studies, incorporating 172 specimens. The findings indicated that fixed angle constructs, specifically the anatomic locking plate, demonstrated superior axial stiffness (mean difference [MD]: 23.59 N/mm; 95% CI 8.12–39.06) in comparison to the cross screw. Additionally, the blade plate construct excelled in bending stiffness (MD: 32.37 N/mm; 95% CI − 47.37 to 112.11) relative to the cross screw construct, while the cross-screw construct proved to be the most robust in terms of bending load failure. The parallel screw construct performed optimally in torsional stiffness (MD: 139.39 Nm/degree; 95% CI 0.79–277.98) when compared to the cross screw construct. Lastly, the nonlocking plate, locking T plate, and cross-pin constructs were found to be inferior in most respects to alternative interventions. The NMA indicated that fixed angle devices (blade plate and anatomic locking plate) and screw fixations may exhibit enhanced biomechanical strength in axial and bending directions, whereas cross screws demonstrated reduced torsional stability in comparison to parallel screws. It is imperative for clinicians to consider the application of these findings in constraining forces across various directions during early range of motion exercises, taking into account the distinct biomechanical properties of the respective implants.

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Section: Discussionmentioning

confidence: 99%

Is implant choice associated with fixation strength for displaced radial neck fracture: a network meta-analysis of biomechanical studies

Su¹,

Wang²,

Fang³

et al. 2023

Sci Rep

View full text Add to dashboard Cite

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“…Least-distance distributions between surfaces for the radius and scaphoid models, radius and lunate models, and ulna and lunate models were calculated from a point-to-point distance calculation algorithm using custom-written software [ 19 , 20 ]. Articular contact areas were defined as those areas where least distances were below a certain threshold.…”

Section: Methodsmentioning

confidence: 99%

Effect of the Sauvé–Kapandji method on the wrist contact surface for distal radial ulnar joint disorders

Suzuki,

Momma,

Inoue

et al. 2024

BMC Musculoskelet Disord

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Background The Sauvé–Kapandji (S-K) method is a surgical procedure performed for chronic deformities of the distal radial ulnar joint (DRUJ). Changes to the joint contact surface from pre- to postoperatively under physiological in vivo conditions have not yet been determined for this useful treatment. The aim of the present study was therefore to compare the articular contact area of the wrist joint between before and after the S-K method for DRUJ disorders. Methods The SK method was performed for 15 patients with DRUJ osteoarthritis and ulnar impaction syndrome. We calculated the Mayo Wrist Score as the patient’s clinical findings and created 3-dimensional bone models of cases in which the S-K method was performed and calculated the contact area and shift in the center of the contact area using customized software. Results The Mean modified Mayo Wrist Score improved significantly from 60.3 preoperatively to 80.3 postoperatively (P < 0.01). Scaphoid contact area to the radius increased significantly from 112.6 ± 37.0 mm2 preoperatively to 127.5 ± 27.8 mm2 postoperatively (P = 0.03). Lunate contact area to radius-ulna was 121.3 ± 43.3 mm2 preoperatively and 112.5 ± 37.6 mm2 postoperatively, but this decrease was not significant (P = 0.38). Contact area ratio of scaphoid to lunate increased significantly from 1.01 ± 0.4 preoperatively to 1.20 ± 0.3 postoperatively (P = 0.02). Postoperative translations of the center of the scaphoid and lunate contact areas were decomposed into ulnar and proximal directions. Ulnar and proximal translation distances of the scaphoid contact area were 0.8 ± 1.7 mm and 0.4 ± 0.6 mm, respectively, and those of the lunate contact area were 1.1 ± 1.7 mm and 0.4 ± 1.1 mm, respectively. This study revealed changes in wrist contact area and center of the contact area before and after the S-K method. Conclusion These results may accurately indicate changes in wrist joint contact area from pre- to postoperatively using the S-K method for patients with DRUJ disorder. Evaluation of changes in contact area due to bone surface modeling of the wrist joint using 3DCT images may be useful in considering surgical methods.

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“…These 3D scapula and humerus bone models were then analyzed with a customized software created in Microsoft Visual C + + with Microsoft Foundation Class programming environment (Microsoft, Redmond, WA) for further analysis 23 , 24 . The glenohumeral contact area, center of glenohumeral contact area, and center of humeral head were analyzed with a customized software 25 . Articular contact areas were defined as areas where the least distances were under a certain threshold level.…”

Section: Methodsmentioning

confidence: 99%

Four-dimensional computed tomography evaluation of shoulder joint motion in collegiate baseball pitchers

Momma

Orías

Irie

et al. 2022

Sci Rep

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The purpose of this study is to evaluate the glenohumeral contact area, center of glenohumeral contact area, and center of humeral head during simulated pitching motion in collegiate baseball pitchers using four-dimensional computed tomography (4D CT). We obtained 4D CT data from the dominant and non-dominant shoulders of eight collegiate baseball pitchers during the cocking motion. CT image data of each joint were reconstructed using a 3D reconstruction software package. The glenohumeral contact area, center of glenohumeral contact area, center of humeral head, and oblateness of humeral head were calculated from 3D bone models using customized software. The center of glenohumeral contact area translated from anterior to posterior during maximum external rotation to maximum internal rotation (0.58 ± 0.63 mm on the dominant side and 0.99 ± 0.82 mm on the non-dominant side). The center of humeral head translated from posterior to anterior during maximum external rotation to maximum internal rotation (0.76 ± 0.75 mm on the dominant side and 1.21 ± 0.78 mm on the non-dominant side). The increase in anterior translation of the center of glenohumeral contact area was associated with the increase in posterior translation of the center of humeral head. Also, the increase in translation of the center of humeral head and glenohumeral contact area were associated with the increase in oblateness of the humeral head. 4D CT analyses demonstrated that the center of humeral head translated in the opposite direction to that of the center of glenohumeral contact area during external rotation to internal rotation in abduction in the dominant and non-dominant shoulders. The oblateness of the humeral head may cause this diametric translation. 4D CT scanning and the software for bone surface modeling of the glenohumeral joint enabled quantitative assessment of glenohumeral micromotion and be used for kinematic evaluation of throwing athletes.

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Changes in elbow joint contact area in symptomatic valgus instability of the elbow in baseball players

Cited by 5 publications

References 27 publications

Is implant choice associated with fixation strength for displaced radial neck fracture: a network meta-analysis of biomechanical studies

Is implant choice associated with fixation strength for displaced radial neck fracture: a network meta-analysis of biomechanical studies

Effect of the Sauvé–Kapandji method on the wrist contact surface for distal radial ulnar joint disorders

Four-dimensional computed tomography evaluation of shoulder joint motion in collegiate baseball pitchers

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