The Bio-Mechanical Development and Kinematic Evaluation of Zone I and Zone II Injuries and their Corresponding Surgical Repair Techniques using an In-Vitro Active Finger Motion Simulator: A Cadaveric Study
Doctor of Philosophy
Musculoskeletal Health Research
Ferreira, Louis M.
Research development involving large scale joint mechanics and biomechanical adaptations is growing. However, interest in smaller scale joints, such as the fingers, is limited. Thus, the present work describes the enhancement and clinical application of a previously designed in-vitro active finger motion simulator in measuring and assessing intrinsic joint kinematics and tissue biomechanics including load transfer and strains induced tissues within the finger. Accuracy of electromagnetic tracking (EM) systems were evaluated compared to the standard optical tracking systems and used to develop motion derived finger joint coordinate systems. Moreover, minute strain gauges were utilized to measure strains induced by the volar plate. Multiple in-vitro studies involving zone I and II injuries and repairs were evaluated where joint motion kinematics, tendon loads, work of flexion (WOF), and volar plate strains were measured. Strains, tendon load, and WOF increased with each progressive injury simulation. Joint kinematics were also significantly influenced with each injury simulation. Subsequent repair of the injuries restored metrics to the near-normal state. The active motion system and the present work advances the knowledge on finger biomechanics and provides researchers with a more detailed and refined insight on the overall effect of different innovate surgical techniques, rehabilitation protocols, and traumatic injuries on the biomechanics of single, or multiple, internal structures.
Summary for Lay Audience
The finger is composed of a series of small delicate group of bones, soft tissues, and joints that function together to simulate smooth motion. They are subjected to injuries every day and thus, proper knowledge of the internal structural integrity and the biomechanics of the finger is important for the further development of more advanced and reliable surgical and rehabilitation protocols. There is currently limited advanced research on the biomechanics of the finger, despite how susceptible they are to injury. Previous studies have used different passive and active-assisted motion methods to study the impact of different surgical techniques or suture types. However, the use of a well enhanced device for mimicking and controlling true active finger motion in the literature is lacking. A rigorous framework and understanding of how metrics are biomechanically influenced by different injury conditions and motions is vital. Misguided information or lack of knowledge can result in the overall diminishing of a patient’s quality of care and life. In addition, the use of a standardized design for biomechanical and joint testing will result in more reliable findings between different groups. The purpose of this work is to further enhance a previously developed fully simulated active motion system capable of quantifying and accurately assessing finger motion and load transfers across tissues in order to contribute to the ongoing research in finger biomechanics.
Haddara, Mohammad, "The Bio-Mechanical Development and Kinematic Evaluation of Zone I and Zone II Injuries and their Corresponding Surgical Repair Techniques using an In-Vitro Active Finger Motion Simulator: A Cadaveric Study" (2022). Electronic Thesis and Dissertation Repository. 8424.
Available for download on Monday, April 01, 2024