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A Biomechanical Investigation of Load Sharing at the Distal Forearm

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A Biomechanical Investigation of Load Sharing at the Distal Forearm Western University Scholarship@Western Electronic Thesis and Dissertation Repository 9-5-2017 4:45 PM A Biomechanical Investigation of Load Sharing at the Distal Forearm Martine E. McGregor The University of Western Ontario Supervisor Johnson, James A The University of Western Ontario King, Graham JW The University of Western Ontario Graduate Program in Biomedical Engineering A thesis submitted in partial fulfillment of the equirr ements for the degree in Master of Engineering Science © Martine E. McGregor 2017 Follow this and additional works at: https://ir.lib.uwo.ca/etd Part of the Biomedical Engineering and Bioengineering Commons Recommended Citation McGregor, Martine E., "A Biomechanical Investigation of Load Sharing at the Distal Forearm" (2017). Electronic Thesis and Dissertation Repository. 4944. https://ir.lib.uwo.ca/etd/4944 This Dissertation/Thesis is brought to you for free and open access by Scholarship@Western. It has been accepted for inclusion in Electronic Thesis and Dissertation Repository by an authorized administrator of Scholarship@Western. For more information, please contact [email protected]. Abstract Loading at the distal forearm has been previously examined under static loads, however there remains no consensus on how loading is affected by active wrist and forearm motion. This work examines load magnitudes and load sharing at the distal radius and ulna during of active wrist and forearm motion. Two instrumented implants were designed to measure in vitro loading in cadaveric specimen. The implants were evaluated and found reliable for use in further biomechanical studies. An in vitro study investigated the effect of joint angle and direction of joint motion on loads in the distal radius and ulna during active flexion-extension, radioulnar deviation and dart throw motion. Loads through the distal radius and ulna were significantly greater in extension and reverse dart throw motion than in flexion and forward dart throw motion. A subsequent study examined the effect of radial length changes, joint angle and direction of motion on distal radius and ulna loading during active forearm rotation. Load magnitudes through the distal radius were greater in supination than in pronation. Radial lengthening found to increase radial loading and decrease ulnar loading and radial shortening decreased distal radius loading and increased distal ulna loading throughout forearm rotation, in a quasilinear fashion. This work improves the understanding of forearm bone loading and will assist clinicians in the development of rehabilitation techniques, surgical protocols and implant designs. Keywords: distal radius, distal ulna, bone loading, wrist, forearm, biomechanics, dynamic wrist/forearm motion, Kienbock’s disease i Co-Authorship Statement CHAPTER 1 Sole Author – Martine McGregor CHAPTER 2 Study Design – Martine McGregor, Diana Isa, Jim Johnson, Graham King Data Collection – Martine McGregor, Diana Isa, Mark Welsh, Dan Langohr Data Analysis – Martine McGregor, Dan Langohr Statistical Analysis – Martine McGregor Manuscript Preparations – Martine McGregor Manuscript Revisions – Jim Johnson, Graham King CHAPTER 3 Study Design – Martine McGregor, Diana Isa, Jim Johnson, Graham King Data Collection – Martine McGregor, Diana Isa, Mark Welsh, Clare Padmore, Dan Langohr Data Analysis – Martine McGregor, Dan Langohr Statistical Analysis – Martine McGregor Manuscript Preparations – Martine McGregor Manuscript Revisions – Jim Johnson, Graham King CHAPTER 4 Study Design – Martine McGregor, Diana Isa, Jim Johnson, Graham King Data Collection – Martine McGregor, Diana Isa, Mark Welsh, Clare Padmore, Dan Langohr Data Analysis – Martine McGregor, Dan Langohr Statistical Analysis – Martine McGregor Manuscript Preparations – Martine McGregor Manuscript Revisions – Jim Johnson, Graham King CHAPTER 5 Sole Author – Martine McGregor APPENDIX A Sole Author – Martine McGregor APPENDIX B Sole Author – Martine McGregor APPENDIX C Sole Author – Martine McGregor iii Acknowledgments The work completed for this thesis was possible only through the contributions of many individuals. First and foremost, I would like to thank my advisors Dr. Johnson and Dr. King for their guidance, expertise, and commitment to excellence in research. Dr. Johnson, thank you for your curiosity, patience and kindness. It has been a very special honor to work under such an accomplished academic researcher and professional engineer. Dr. King, thank you for your medical expertise, sense of humor and dedication to the scientific process. I am incredibly grateful for the opportunity you have given me to participate and contribute to the world renowned research you conduct. I would like to thank Diana for being my research partner throughout this project. Thank you for your commitment to this project and holding to your convictions when there was something standing between us and our goals. This work would have taken an insurmountable amount of time if it weren’t for you pushing us through. I would like to thank Dan and Dr. Suh for their contributions as members of my advisory committee. Dan, thank you for both your physical and intellectual contributions to this work. Without you data collection and analysis would not have been possible. Dr. Suh, thank you for your guidance to both Diana and I and thank you for the never-ending supply of motivation, positive energy and of course, Timbits. Thank you to all of my colleagues at the HULC for their mentorship and friendship. Mark and Duncan, thank you for coming out of retirement to assist with this work. A special thank you to Mark who took it upon himself to become an expert on the wrist simulator to assist testing days. Clare and Helen, thank you for pioneering the “Wrist Team” and handing down your knowledge and expertise on the wrist simulator and testing day protocols. Jordan, thank you for your sunny disposition and your willingness to assist with any software or hardware issues that arose throughout testing. Lastly, I would like to thank my family and friends in both Manitoba and Ontario. To my parents, thank you for your unyielding support and always encouraging me to achieve my never ending list of goals. To Josh, thank you for everything and all that you do for me. iv Table of Contents Abstract ................................................................................................................................ i CERTIFICATE OF EXAMINATION ........................................................................... ii Martine Elizabeth McGregor .......................................................................................... ii Co-Authorship Statement................................................................................................... iii Acknowledgments.............................................................................................................. iv Table of Contents .................................................................................................................v List of Figures ......................................................................................................................x List of Tables .....................................................................................................................xv List of Appendices ........................................................................................................... xvi List of Abbreviations ...................................................................................................... xvii Chapter 1 ............................................................................................................................1 1 Introduction .......................................................................................................................1 1.1 Anatomy of the Wrist and Forearm ..............................................................................2 Bony Anatomy .............................................................................................2 Joints ..........................................................................................................14 Ligamentous Anatomy ...............................................................................17 Musculature................................................................................................20 1.2 Wrist Kinematics ........................................................................................................25 Range of Motion ........................................................................................25 1.3 Clinical Disorders of the Wrist and Forearm ..............................................................31 Wrist Fractures ...........................................................................................31 Kienbock’s Disease ....................................................................................33 Ulnar Impaction Syndrome ........................................................................35 v Arthritis ......................................................................................................37 1.4 Load Measurement Techniques ..................................................................................39 Strain Gauges .............................................................................................39 Load Cells ..................................................................................................39 1.5 Distal Forearm Load Sharing ......................................................................................41
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