Development and Validation of a Computational Model for Investigation of Wrist Biomechanics

Abstract

In this study, a computational model of the wrist joint complex was developed and validated for investigating the biomechanical function of the joint in clinically representative scenarios. Joint behavior and kinematics were dictated only by osteoarticular contact, ligamentous constraints, and muscle loading. Three-dimensional articular surfaces of each bone were generated from CT images, while ligaments and muscles were modeled as linear springs and constant-magnitude force vectors, respectively. Commercially available rigid body dynamics software was to both build the model and simulate joint function. Range of motion model predictions were compared to a cadaveric study analyzing the effects of scaphoid distal pole excision and triquetral excision after radioscapholunate (RSL) fusion for validation. The computational model was able to accurately predict flexion, extension, radial deviation, and ulnar deviation motions in four states: normal (intact), RSL fusion, RSL fusion with the scaphoid distal pole excised, and RSL fusion with both the scaphoid distal pole and triquetrum excised. The model was also able to calculate other parameters of interest that are not easily obtainable experimentally, such as midcarpal forces. This model and modeling approach are anticipated to have value as a predictive clinical tool including effect of injuries or anatomical variations and initial outcome of surgical procedures for patient specific planning and custom implant design.

Biomechanische Modellierung der Handwurzel

“…Daher spiegelt die bisherige modelltechnische Approximation der zahlreichen Handwurzelgelenke als lediglich simplifizierte Gelenke nicht die Komplexität wider, die sie physiologisch eigentlich beinhalten. Gerade wegen dieser komplexen Handgelenksverbindung ist das Verständnis der physiologischen und pathologischen Biomechanik wichtig, um die Ursache und die Auswirkungen von Verletzungen und deren chirurgischer Therapie zu verstehen [34]. In dieser Arbeit wurden daher die bestehenden biomechanischen Modellansätze systematisch hinsichtlich ihrer Eignung zur Beantwortung klinischer Fragestellungen in Bezug auf pathologische Veränderungen und Therapie der Handwurzel analysiert.…”

“…Die bisherige Arbeiten haben zwar zum Verständnis der karpalen Interaktionen beigetragen, jedoch existiert bis zum jetzigen Zeitpunkt keine einheitliche und für die Bewegung der gesunden oder kranken Handwurzel validierte Modellansicht respektive Theorie [7,9,18,[35][36][37][38][39]. Es existieren lediglich simplifizierte Beschreibungen und Funktionsmodelle der Handwurzel [18,31,34,35,39]. Unterschiedliche Modalitäten und Versuchsansätze zur Untersuchung der Biomechanik der Handwurzel sowie die Limitierungen, die mit Humanpräparatuntersuchungen einhergehen, und der angewandten Bildgebungsverfahren, können eventuell die Diskrepanzen und Unterschiede in den Modellansichten und Theorien erklären.…”

Subject-specific finite element analysis of the carpal tunnel cross-sectional to examine tunnel area changes in response to carpal arch loading

“…Finite element (FE) representations, representative of patient-specific anatomy, have been utilized to investigate mechanics of different tissues (Martin et al, 2015; Sun et al, 2015). Specific to the wrist, FE analysis has been used to investigate the load transmission through the carpal bones (Carrigan et al, 2003; Gislason et al, 2009), the effects of pathological conditions on wrist joint (Bajuri et al, 2012), wrist mechanics in response to tendon loading (Majors and Wayne, 2011), and changes in carpal load transmission associated with carpal tunnel release (Guo et al, 2009). FE modeling was also used to analyze stress of the carpal tunnel contents and showed that median nerve compression is attributable to structural contact force rather than fluid pressure (Ko and Brown, 2007; Mouzakis et al, 2014).…”

Three-dimensional stiffness of the carpal arch

“…For example, the structural mechanics enables wrist motion (Fischli et al, 2009; Majors and Wayne, 2011), provides stability to the carpal tunnel (Garcia-Elias et al, 1989a), and allows for force transmission between the hand and forearm during hand use, e.g. grasping (Horii et al, 1990; Marquez-Florez et al, 2015; Matsuki et al, 2009; Schuind et al, 1995).…”

“…The two-dimensional mechanics of the wrist have also been investigated with respect to the compliance of the carpal tunnel (Tung et al, 2010), force transmission across wrist (Garcia-Elias et al, 1989b; Schuind et al, 1995), and manipulation of the carpal tunnel's cross-sectional area (Li et al, 2013; Li et al, 2011; Li et al, 2009). Three-dimensional studies of the wrist structure have been mainly studied with computational modeling with a particular focus on force transmission across the carpus (Fischli et al, 2009; Guo et al, 2009; Majima et al, 2008; Majors and Wayne, 2011; Marquez-Florez et al, 2015; Matsuki et al, 2009). However, there is a lack of experimental studies investigating the three-dimensional biomechanics of the wrist structure.…”