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首页> 外文期刊>Journal of Biomechanics >Interphalangeal joint and tendon forces: normal model and biomechanical consequences of surgical reconstruction.
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Interphalangeal joint and tendon forces: normal model and biomechanical consequences of surgical reconstruction.

机译：指间关节和腱力：手术重建的正常模型和生物力学后果。

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摘要

Soft tissue reconstructive surgery for rheumatoid-related proximal interphalangeal joint deformities frequently fails to produce the long-term predicted results. Detailed information on the biomechanics of this joint, under both normal and pathological conditions, is required to assess the efficacy of such surgical intervention. A biomechanical model of the proximal interphalangeal joint has been developed to investigate tendon and joint loading during real life three-dimensional activities. Based on a rigid body mechanics approach, the model uses high resolution MRI scans to obtain anatomical tendon and bone geometries in conjunction with three-dimensional kinematic and loading data. The model incorporates an optimisation routine which minimises overall maximum tendon stress in the eight individual elements considered. Radial and ulnar joint force components are included at the proximal interphalangeal joint level. Two simulated pathological versions of the mathematical model are developed to accommodate the altered anatomic relationships after tendon reconstructive surgery. Joint forces of up to 450N and common usage of the extensor mechanism during normal pinching and grasping activities are predicted. The ulnar lateral bands of the extensor tendon are generally loaded to a greater extent than the radial bands. Extensor tendon and joint forces in the simulated pathological models are significantly higher than those in the normal model. Combined with the poor tendon quality of rheumatoid arthritis patients generally, these amplified internal forces may lead to further joint deformation.
机译：类风湿相关的近端指间关节畸形的软组织重建手术通常无法产生长期的预测结果。在正常和病理条件下，都需要有关该关节生物力学的详细信息，以评估此类手术干预的有效性。已经开发了近端指间关节的生物力学模型，以研究现实生活中的三维活动中的肌腱和关节负荷。该模型基于刚体力学方法，结合高分辨率的三维运动学和载荷数据，使用高分辨率的MRI扫描来获取解剖腱和骨骼的几何形状。该模型包含一个优化例程，该例程可以使所考虑的八个单独元素中的最大最大腱应力最小化。 pha骨和尺骨关节分力包括在近端指间关节水平。开发了数学模型的两个模拟病理版本，以适应腱重建手术后改变的解剖关系。可以预测在正常的捏和抓握活动中，关节力可达450N，伸肌机构通常会使用。伸肌腱的尺侧带通常比径向带承受更大的负荷。在模拟的病理模型中，伸肌腱和关节力显着高于正常模型。通常，结合类风湿关节炎患者肌腱质量较差的情况，这些放大的内力可能导致关节进一步变形。

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