Aix-Marseille University, CNRS, ISM, 163 Avenue de Luminy BP 910 -13288, Cedex 09, Marseille, France.
Aix-Marseille University, APHM, CNRS, ISM, St Marguerite Hospital, Institute for Locomotion, Marseille, France.
Med Biol Eng Comput. 2022 Sep;60(9):2537-2547. doi: 10.1007/s11517-022-02624-x. Epub 2022 Jul 2.
Distal interphalangeal joint arthrodesis is a frequent surgical operation performed to treat severe arthritis. Nevertheless, the angle selected when fusing the joint is arbitrarily chosen without any quantified data concerning its mechanical effects, thus preventing the optimal choice for the patient. In the current study, we realized an experiment and developed a numerical model to investigate the effect of fusion angle on the biomechanics of adjacent non-operated joints. Six participants performed a pinch grip task while arthrodesis was simulated with a metal splint. Kinematic and force data were recorded during this task and used in a biomechanical model to estimate contact pressures in adjacent joints. The biomechanical model involved combining a multibody system and a finite element method. Results showed that the angle of any distal interphalangeal joint arthrodesis influences index finger kinematics and maximal grip force in several participants. For one participant, in the arthrodesis simulation, we observed an increase of 1.9 MPa in the proximal interphalangeal joint contact pressure. Our results provide quantified information about the biomechanical consequences of this surgical operation and its potential long-term effects.
远节指间关节融合术是一种常见的手术，用于治疗严重的关节炎。然而，在融合关节时选择的角度是任意选择的，没有任何关于其机械效果的量化数据，因此无法为患者提供最佳选择。在本研究中，我们进行了一项实验并开发了一个数值模型，以研究融合角度对相邻未手术关节生物力学的影响。六名参与者在使用金属夹板模拟关节融合时进行了捏夹任务。在该任务期间记录运动学和力数据，并将其用于生物力学模型以估计相邻关节的接触压力。生物力学模型涉及结合多体系统和有限元方法。结果表明，任何远节指间关节融合术的角度都会影响几位参与者的食指运动学和最大握力。对于一名参与者，在关节融合模拟中，我们观察到近节指间关节接触压力增加了 1.9 MPa。我们的结果提供了有关该手术的生物力学后果及其潜在长期影响的量化信息。
