Bauknecht Simon, Mentzel Martin, Vergote Daniel, Andreas Myriam, Moeller Richard-Tobias
Unfall-, Hand-, Plastische u. Wiederherstellungschirurgie, Universitätsklinikum Ulm, Ulm, Germany.
Handchir Mikrochir Plast Chir. 2022 Sep;54(5):418-426. doi: 10.1055/a-1894-7002. Epub 2022 Sep 7.
Distal interphalangeal joint (DIPJ) arthrodesis is a well-proven therapy for osteoarthritis in the DIPJ. Since the upper limb is effectively a linked chain which is moved by interlinked, joint-overlapping muscle-tendon units, impacts on movement and force patterns are expected to occur in response to arthrodesis. In this context, a real-time quantitative analysis has not been performed to date.
Finger motion and force development during grasping were dynamically measured and quantitatively analyzed in 19 healthy volunteers with a simulated DIPJ arthrodesis using a TUB (Technische Universität Berlin) sensor glove during fist closure and evaluating two types of force grips compared with the physiological grip.
Typical motion patterns were found. During physiological fist closure, the average flexion angle was 71.5° in the metacarpophalangeal joint (MPJ), 76.8° in the proximal interphalangeal joint (PIPJ) and 37.3° in the distal interphalangeal joint (DIPJ). With DIPJ arthrodesis, the flexion angle decreased to 49.6° in the PIPJ, whereas it increased slightly to 77.3° in the MPJ. During force grip I, the average physiological flexion angles were 18.3° in the MPJ, 39.6° in the PIPJ and 42.6° in the DIPJ. With simulated DIPJ arthrodesis, the flexion angle in the MPJ increased to 28.4°, whereas it decreased to 25.2° in the PIPJ. Force grip II yielded physiological flexion angles of 30.9° in the MPJ, 36.6° in the PIPJ and 29.0° in the DIPJ. In response to simulated DIPJ arthrodesis, the angle in the MPJ increased to 34.4° while it decreased to 23.3° in the PIPJ. The forces measured with force grips were almost equally distributed under physiological conditions. In response to simulated DIPJ arthrodesis, the average decrease in the measured force of a finger was no more than 1.4%.
This study was the first to introduce a quantitative analysis of grasping with simulated DIPJ arthrodesis. Based on this analysis, the study demonstrates the dynamic interaction of the finger joints as well as force patterns on the individual finger rays of the hand in real-time.
远侧指间关节（DIPJ）融合术是治疗DIPJ骨关节炎的一种经充分验证的疗法。由于上肢实际上是一个由相互连接、关节重叠的肌腱单元驱动的连锁链，因此预计DIPJ融合术会对运动和力的模式产生影响。在此背景下，迄今为止尚未进行实时定量分析。
在19名健康志愿者中，使用柏林工业大学（TUB）传感器手套在握拳过程中动态测量并定量分析模拟DIPJ融合术时的手指运动和抓握力发展情况，并评估两种类型的强力抓握与生理性抓握相比的情况。
发现了典型的运动模式。在生理性握拳过程中，掌指关节（MPJ）的平均屈曲角度为71.5°，近端指间关节（PIPJ）为76.8°，远侧指间关节（DIPJ）为37.3°。在DIPJ融合术的情况下，PIPJ的屈曲角度降至49.6°，而MPJ的屈曲角度略有增加至77.3°。在强力抓握I过程中，MPJ的平均生理性屈曲角度为18.3°，PIPJ为39.6°，DIPJ为42.6°。在模拟DIPJ融合术时，MPJ的屈曲角度增加到28.4°，而PIPJ的屈曲角度降至25.2°。强力抓握II时，MPJ的生理性屈曲角度为30.9°，PIPJ为36.6°，DIPJ为29.0°。在模拟DIPJ融合术时，MPJ的角度增加到34.4°，而PIPJ的角度降至23.3°。在生理性条件下，用强力抓握测量的力几乎均匀分布。在模拟DIPJ融合术时，手指测量力的平均下降不超过1.4%。
本研究首次对模拟DIPJ融合术的抓握进行了定量分析。基于该分析，该研究实时展示了手指关节的动态相互作用以及手部各手指指骨上的力模式。
