Distal Humeral Trochlear Geometry Associated With the Spatial Variation of the Dynamic Elbow Flexion Axis
Background: The complexity of the spatial dynamic flexion axis (DFA) of the elbow joint makes the elbow prosthesis design and humeral component alignment challenging. This study aimed to 1) investigate the variations of the spatial DFA during elbow flexion and 2) investigate the relationship between...
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Published in | Frontiers in bioengineering and biotechnology Vol. 10; p. 850198 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Frontiers Media S.A
24.06.2022
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Subjects | |
Online Access | Get full text |
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Summary: | Background:
The complexity of the spatial dynamic flexion axis (DFA) of the elbow joint makes the elbow prosthesis design and humeral component alignment challenging. This study aimed to 1) investigate the variations of the spatial DFA during elbow flexion and 2) investigate the relationship between the distal humeral trochlear geometry and the
in vivo
spatial variation of the DFA.
Methods:
Ten healthy subjects participated in this study. Each subject performed a full elbow extension to maximum flexion with hand supination under dual fluoroscopic imaging system (DFIS) surveillance. The 2D fluoroscopic images and the 3D bone models were registered to analyze the
in vivo
elbow kinematics and DFAs. The spatial DFA positions were defined as inclination with the medial and lateral epicondyle axes (MLA) in the transverse and coronal planes. The range of the DFA positions was also investigated during different flexion phases. The Spearman correlation method was used to analyze the relationship between the distal humeral trochlear’s morphological parameters and the position of DFAs during different flexion phases.
Results:
The pathway of the DFAs showed an irregular pattern and presented individual features. The medial trochlear depth (MTD) (
r
= 0.68,
p
= 0.03) was positively correlated with the range of the DFA position (2.8° ± 1.9°) in the coronal plane from full extension to 30° of flexion. Lateral trochlear height (LTH) (
r
= −0.64,
p
= 0.04) was negatively correlated with the DFA position (−1.4° ± 3.3°) in the transverse plane from 30° to 60° of flexion. A significant correlation was found between LTH with the DFA position in the coronal (
r
= −0.77,
p
= 0.01) and transverse planes (
r
= −0.76,
p
= 0.01) from 60° to 90° of flexion.
Conclusion:
This study showed that the pathway of the dynamic flexion axis has an individual pattern. The medial and lateral trochlear sizes were the key parameters that might affect the elbow joint flexion function. When recovering complex distal humeral fractures or considering the implant design of total elbow arthroplasty, surgeons should pay more attention to the medial and lateral trochlea’s geometry, which may help restore normal elbow kinematics. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Jay Trivedi, Rhode Island Hospital, United States Reviewed by: Ding Jian, Shanghai Jiao Tong University, China These authors have contributed equally to this work Edited by: Jun Pan, Chongqing University, China This article was submitted to Biomechanics, a section of the journal Frontiers in Bioengineering and Biotechnology |
ISSN: | 2296-4185 2296-4185 |
DOI: | 10.3389/fbioe.2022.850198 |