The Biomechanical Basis of the Claw Finger Deformity: A Computational Simulation Study

Binder-Markey, Benjamin I.; Dewald, Julius P. A.; Murray, Wendy M.

doi:10.1016/j.jhsa.2019.05.007

Cited by 13 publications

(10 citation statements)

References 27 publications

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“…This pattern is similar to what is observed with intrinsic wasting in the hand. As the intrinsic muscles atrophy and finger flexor muscles adaptively shorten, there is a tendency toward clawing of the fingers [41]. It seems that the foot may follow a similar pattern in which the lower leg musculature is recruited in anticipation of standing, but the foot intrinsic muscles are unable to counterbalance the pull of the toe extensors and shortening of the toe flexors.…”

Section: Discussionmentioning

confidence: 99%

Multi-System Factors Associated with Metatarsophalangeal Joint Deformity in Individuals with Type 2 Diabetes

Zellers

Mueller

Commean

et al. 2020

JCM

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The underlying factors contributing to metatarsophalangeal joint deformity, a known precursor to skin breakdown in individuals with diabetes mellitus (DM), is likely to involve multiple body systems. The purpose of this cross-sectional study was to identify multi-system factors associated with metatarsophalangeal joint deformity in individuals with type 2 DM and peripheral neuropathy (n = 60). Metatarsophalangeal joint deformity was quantified with a computed tomography (CT) scan. System biomarkers included the musculoskeletal system (foot intrinsic muscle deterioration, tarsal/metatarsal bone mineral density, ankle dorsiflexion, metatarsophalangeal extension movement during a sit to stand task); the vascular system (ankle-brachial index); and the endocrine/immune systems (high sensitivity C-reactive protein, skin intrinsic fluorescence, and hemoglobin A1C). Muscle deterioration (r = 0.27), bone density (r = −0.35), metatarsophalangeal extension movement (r = 0.50), maximum dorsiflexion (r = −0.31), and ankle-brachial index (r = 0.33) were related to metatarsophalangeal joint deformity (p < 0.05). Bone mineral density and metatarsophalangeal extension movement were retained in a regression model relating to deformity (R2 = 0.34). All musculoskeletal system biomarkers and the ankle-brachial index demonstrated weak to moderate relationships to metatarsophalangeal joint deformity. Bone mineral density of the tarsal/metatarsal bones and extending the toes during a sit to stand task were the two strongest factors associated with metatarsophalangeal joint deformity. Evaluation and management of foot bone mineral density and toe extension movement pattern could reduce metatarsophalangeal joint deformity and the risk of skin breakdown and subsequent amputation.

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Section: Discussionmentioning

confidence: 99%

Multi-System Factors Associated with Metatarsophalangeal Joint Deformity in Individuals with Type 2 Diabetes

Zellers

Mueller

Commean

et al. 2020

JCM

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“…The model includes passive joint properties for all flexion/extension DOFs of the phalanges and thumb, for CMC ab-adduction of the thumb, and for wrist flexion and deviation DOFs. Passive joint properties for the fingers and thumb DOFs were implemented as position-dependent torques [2,5,6]. Passive properties for the thumb and index finger were implemented from the literature [25,[34][35][36], as described in previous work [1,6].…”

Section: Model Developmentmentioning

confidence: 99%

“…OMPUTATIONAL musculoskeletal models of the hand and wrist provide valuable insight into how hand dysfunction occurs following changes to specific musculoskeletal structures [1], neural control signals [2], and functional use [3]. However, due to the complexity of the hand and limited physiological data characterizing the middle, ring, and little fingers, most hand models are used in simulations involving only the thumb and/or index finger [1,2,[4][5][6][7][8][9][10][11][12]. As a result, more complex functional tasks that require coordinated effort from all the digits (e.g., grasping, hand opening) have rarely been simulated.…”

Section: Introductionmentioning

confidence: 99%

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A Musculoskeletal Model of the Hand and Wrist Capable of Simulating Functional Tasks

McFarland

Binder-Markey

Nichols

et al. 2021

Preprint

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Objective: The purpose of this work was to develop an open-source musculoskeletal model of the hand and wrist and to evaluate its performance during simulations of functional tasks. Methods: The musculoskeletal model was developed by adapting and expanding upon existing musculoskeletal models. An optimal control theory framework that combines forward-dynamics simulations with a simulated-annealing optimization was used to simulate maximum grip and pinch force. Active and passive hand opening were simulated to evaluate coordinated kinematic hand movements. Results: The model's maximum grip force production matched experimental measures of grip force, force distribution amongst the digits, and displayed sensitivity to wrist flexion. Simulated lateral pinch strength fell within variability of in vivo palmar pinch strength data. Additionally, predicted activation for 7 of 8 muscles fell within variability of EMG data during palmar pinch. The active and passive hand opening simulations predicted reasonable activations and demonstrated passive motion mimicking tenodesis, respectively. Conclusion: This work advances simulation capabilities of hand and wrist models and provides a foundation for future work to build upon. Significance: This is the first open-source musculoskeletal model of the hand and wrist to be implemented during both functional kinetic and kinematic tasks. We provide a novel simulation framework to predict maximal grip and pinch force which can be used to evaluate how potential surgical and rehabilitation interventions influence these functional outcomes while requiring minimal experimental data.

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“…The human hand has the most sophisticated anatomy, including 27 bones, numerous muscles, tendons, ligaments, and other anatomical structures [ 1 ], which allows for a variety of complex and delicate movements. Many studies have long been conducted on the motor mechanisms of the hand [ 2 , 3 ], hand diseases [ 4 , 5 ], and bionic applications [ 6 – 8 ]. The main methods for studying the motor mechanism of the hand are muscle electrical signals (EMG) and numerical models of the hand.…”

Section: Introductionmentioning

confidence: 99%

Analysis on synergistic cocontraction of extrinsic finger flexors and extensors during flexion movements: A finite element digital human hand model

Zheng

Chen

et al. 2022

PLoS ONE

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Fine hand movements require the synergistic contraction of intrinsic and extrinsic muscles to achieve them. In this paper, a Finite Element Digital Human Hand Model (FE-DHHM) containing solid tendons and ligaments and driven by the Muscle-Tendon Junction (MTJ) displacements of FDS, FDP and ED measured by ultrasound imaging was developed. The synergistic contraction of these muscles during the finger flexion movements was analyzed by simulating five sets of finger flexion movements. The results showed that the FDS and FDP contracted together to provide power during the flexion movements, while the ED acted as an antagonist. The peak stresses of the FDS, FDP and ED were all at the joints. In the flexion without resistance, the FDS provided the main driving force, and the FDS and FDP alternated in a "plateau" of muscle force. In the flexion with resistance, the muscle forces of FDS, FDP, and ED were all positively correlated with fingertip forces. The FDS still provided the main driving force, but the stress maxima occurred in the FDP at the DIP joint.

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The Biomechanical Basis of the Claw Finger Deformity: A Computational Simulation Study

Cited by 13 publications

References 27 publications

Multi-System Factors Associated with Metatarsophalangeal Joint Deformity in Individuals with Type 2 Diabetes

Multi-System Factors Associated with Metatarsophalangeal Joint Deformity in Individuals with Type 2 Diabetes

A Musculoskeletal Model of the Hand and Wrist Capable of Simulating Functional Tasks

Analysis on synergistic cocontraction of extrinsic finger flexors and extensors during flexion movements: A finite element digital human hand model

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