Musculoskeletal simulation of elbow stability for common injury patterns

  • Elbow stability is derived from a combination of muscular, ligamentous, and bony structures. After an elbow trauma the stability of the joint is an important decision criterion for the subsequent treatment. The decision regarding non-operative/operative care depends mostly on subjective assessments of medical experts. Therefore, the aim of this study is to use musculoskeletal simulations as an objective assessment tool to investigate the extent to which failure of different stabilizers affects the elbow stability and how these observations correspond to the assessment from clinical practice. A musculoskeletal elbow simulation model was developed for this aim. To investigate the stability of the elbow, varus/valgus moments were applied under 0°, 45°and 90° flexion while the respective cubital angle was analyzed. This was performed for nine different injury scenarios, which were also evaluated for stability by clinical experts. With the results, it can be determined by which injury pattern and under which flexion angle the elbow stability is impaired regarding varus/valgus moments. The scenario with a complete failure of the medial and lateral ligaments and a fracture of the radial head was identified as having the greatest instability. The study presented a numerical determination of elbow stability against varus/valgus moments regarding clinical injury patterns, as well as a comparison of the numerical outcome with experience gained in clinical practice. The numerical predictions agree well with the assessments of the clinical specialists. Thus, the results from musculoskeletal simulation can make an important contribution to a more objective assessment of the elbow stability.

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Author:Maximilian MelznerORCiD, Christian Pfeiffer, Franz Suess, Sebastian DendorferORCiD
Parent Title (English):Journal of Orthopaedic Research
Document Type:Article
Year of first Publication:2022
Publishing Institution:Ostbayerische Technische Hochschule Regensburg
Release Date:2022/10/13
Tag:AnyBody; elbow stability; musculoskeletal simulation
First Page:1356
Last Page:1364
Corresponding author: Maximilian Melzner
Institutes:Fakultät Maschinenbau
Regensburg Center of Biomedical Engineering - RCBE
Regensburg Center of Health Sciences and Technology - RCHST
Fakultät Maschinenbau / Labor Biomechanik (LBM)
research focus:Lebenswissenschaften und Ethik
OpenAccess Publikationsweg:Hybrid Open Access - OA-Veröffentlichung in einer Subskriptionszeitschrift/-medium
Corresponding author der OTH Regensburg
Funding:DEAL Wiley
Licence (German):Creative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International
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