Biomechanical study of the effect of traction on elbow joint capsule contracture

Fang Wang; Jiaming Wang; Mingxin Li; Jun Hu; Kehua Song; Jianguo Zhang; Yubo Fan; Fang Wang; Jiaming Wang; Mingxin Li; Jun Hu; Kehua Song; Jianguo Zhang; Yubo Fan

doi:10.3934/mbe.2023949

Mathematical Biosciences and Engineering

2023, Volume 20, Issue 12: 21451-21466. doi: 10.3934/mbe.2023949

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Research article

Biomechanical study of the effect of traction on elbow joint capsule contracture

1.
College of Mechanical Engineering, The Key Laboratory of Integrated Design and On-Line Monitoring of Light Industrial and Food Engineering Machinery and Equipment in Tianjin, Tianjin University of Science & Technology, Tianjin 300222, China
2.
Key Laboratory of Rehabilitation Aids Technology and System of the Ministry of Civil Afairs, National Research Center for Rehabilitation Technical Aids, Beijing 100176, China
3.
Department of Traumatic Orthopaedics, Tianjin Hospital, Tianjin 300299, China
4.
Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Sciences and Medical Engineering, Beihang University, Beijing 100083, China
5.
Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing 100083, China
† The authors contributed equally to this work

Received: 22 August 2023 Revised: 17 November 2023 Accepted: 22 November 2023 Published: 04 December 2023

Dynamic orthoses have a significant effect on the treatment of elbow capsular contracture. Because of the lack of quantitative research on traction forces, determining the appropriate traction force to help stretch soft tissues and maintain the joint's range of motion is a challenge in the rehabilitation process. We developed a human elbow finite element (FE) model incorporating the activity behavior of the muscles and considering different capsular contracture locations, including total, anterior and posterior capsular contractures, to analyze the internal biomechanical responses of different capsular contracture models during flexion (30 to 80 degrees). Traction loads of 10, 20, 30 and 40 N were applied to the ulna and radius at the maximum flexion angle (80 degrees) to explore the appropriate traction loads at week 4 after a joint capsule injury. We observed a significant increase in posterior capsule stress with anterior capsular contracture (ACC), and the maximum peak stress was 1.3 times higher than that in the healthy model. During the fourth week after elbow capsule injury, the appropriate traction forces for total capsule contracture (TCC), ACC and posterior capsule contracture (PCC) were 20, 10 and 20 N, respectively; these forces maintained a stable biomechanical environment for the elbow joint and achieved a soft tissue pulling effect, thus increasing elbow mobility. The results can be used as a quantitative guide for the rehabilitation physicians to determine the traction load for a specific patient.
- elbow joint contracture,
- finite element analysis,
- computational elbow model,
- stress,
- tractive force
Citation: Fang Wang, Jiaming Wang, Mingxin Li, Jun Hu, Kehua Song, Jianguo Zhang, Yubo Fan. Biomechanical study of the effect of traction on elbow joint capsule contracture[J]. Mathematical Biosciences and Engineering, 2023, 20(12): 21451-21466. doi: 10.3934/mbe.2023949

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Abstract

Dynamic orthoses have a significant effect on the treatment of elbow capsular contracture. Because of the lack of quantitative research on traction forces, determining the appropriate traction force to help stretch soft tissues and maintain the joint's range of motion is a challenge in the rehabilitation process. We developed a human elbow finite element (FE) model incorporating the activity behavior of the muscles and considering different capsular contracture locations, including total, anterior and posterior capsular contractures, to analyze the internal biomechanical responses of different capsular contracture models during flexion (30 to 80 degrees). Traction loads of 10, 20, 30 and 40 N were applied to the ulna and radius at the maximum flexion angle (80 degrees) to explore the appropriate traction loads at week 4 after a joint capsule injury. We observed a significant increase in posterior capsule stress with anterior capsular contracture (ACC), and the maximum peak stress was 1.3 times higher than that in the healthy model. During the fourth week after elbow capsule injury, the appropriate traction forces for total capsule contracture (TCC), ACC and posterior capsule contracture (PCC) were 20, 10 and 20 N, respectively; these forces maintained a stable biomechanical environment for the elbow joint and achieved a soft tissue pulling effect, thus increasing elbow mobility. The results can be used as a quantitative guide for the rehabilitation physicians to determine the traction load for a specific patient.

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