Development and Assessment of an Impact Apparatus and High-Speed Camera Motion Tracking System to Quantify the Effect of Static Muscle Loads on Fracture Threshold Measures in the Distal Radius

Distal radius fractures are prevalent, debilitating, and costly. This thesis conducts an in vitro investigation of these injuries, examining the role of static muscle loading on fracture threshold measures (i.e., force, impulse, energy). Initially, an impact apparatus and custom LabVIEW colour-thresholding program were designed and assessed for repeatability and accuracy in quantifying fracture measures and impact kinematics. These tools were then used to test six pairs of cadaveric forearms, with static muscle loads simulated in one specimen from each pair. Distal radius fractures were achieved in 5 pairs, with perilunate dislocations in the remaining pair. None of the fracture threshold measures assessed presented differences attributed to the muscle forces applied. With the appropriate impact apparatus and colour-thresholding techniques now developed and validated, future testing will examine the effects of higher muscle loads to determine if they may have an effect of the fracture threshold of the distal radius.

Keywords: Distal Radius Fracture; Fracture; Radius; Muscle Force; Perilunate Dislocation; Impact; Colour-Thresholding; Motion Tracking

Year	Entry
2007	Cristofolini L, Juszczyk M, Martelli S, Taddei F, Viceconti M. In vitro replication of spontaneous fractures of the proximal human femur. J Biomech. 2007;40(13):2837-2845.
1998	Hsiao ET, Robinovitch SN. Common protective movements govern unexpected falls from standing height. J Biomech. January 1998;31(1):1-9.
2002	Funk JR, Crandall JR, Tourret LJ, MacMahon CB, Bass CR, Patrie JT, Khaewpong N, Eppinger RH. The axial injury tolerance of the human foot/ankle complex and the effect of Achilles tension. J Biomech Eng. 2002;124(6):750-757.
2007	Troy KL, Grabiner MD. Off-axis loads cause failure of the distal radius at lower magnitudes than axial loads: a finite element analysis. J Biomech. 2007;40(8):1670-1675.
2009	de Bakker PM, Manske SL, Ebacher V, Oxland TR, Cripton PA, Guy P. During sideways falls proximal femur fractures initiate in the superolateral cortex: evidence from high-speed video of simulated fractures. J Biomech. August 25, 2009;42(12):1917-1925.
1990	Winter DA. Biomechanics and Motor Control of Human Movement. 2nd ed. New York, NY: Inc., John Wiley & Sons; 1990.
1979	Amis AA, Dowson D, Wright V. Muscle strengths and musculoskeletal geometry of the upper limb. Eng Med. 1979;8(1):41.
2009	Quenneville CE. Experimental and Numerical Assessments of Injury Criteria for Short-Duration, High-Force Impact Loading of the Tibia [PhD thesis]. University of Western Ontario; December 2009.
1993	Myers ER, Hecker AT, Rooks DS, Hipp JA, Hayes WC. Geometric variables from DXA of the radius predict forearm fracture load in vitro. Calcif Tiss Int. March 1993;52(3):199-204.
1986	Yoganandan N, Sances A Jr, Maiman DJ, Myklebust JB, Pech P, Larson SJ. Experimental spinal injuries with vertical impact. Spine. November 1986;11(9):855-860.
1979	Shrout PE, Fleiss JL. Intraclass correlations: uses in assessing rater reliability. Psychol Bull. 1979;86(2):420-428.
1993	Nevitt MC, Cummings SR; Study of Osteoporofic Fractures Research Group. Type of fall and risk of hip and wrist fractures: the study of osteoporotic fractures. J Am Geriatr Soc. November 1993;41(11):1226-1234.
1997	Ray NF, Chan JK, Thamer M, Melton LJ III. Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation. J Bone Miner Res. January 1997;12(1):24-35.
2001	van Staa TP, Dennison EM, Leufkens HGM, Cooper C. Epidemiology of fractures in England and Wales. Bone. January 2001;29(6):517-522.
1966	McElhaney JH. Dynamic response of bone and muscle tissue. J Appl Physiol. 1966;21(4):1231-1236.
1998	Augat P, Iida H, Jiang Y, Diao E, Genant HK. Distal radius fractures: mechanisms of injury and strength prediction by bone mineral assessment. J Orthop Res. August 1998;16(5):629-635.
1997	Yoganandan N, Pintar FA, Kumaresan S, Boynton M. Axial impact biomechanics of the human foot-ankle complex. J Biomech Eng. November 1997;119(4):433-437.
1996	Augat P, Reeb H, Claes LE. Prediction of fracture load at different skeletal sites by geometric properties of the cortical shell. J Bone Miner Res. September 1996;11(9):1356-1363.
2005	Holzbaur KRS, Murray WM, Delp SL. A model of the upper extremity for simulating musculoskeletal surgery and analyzing neuromuscular control. Ann Biomed Eng. June 2005;33(6):829-840.
2011	Burkhart TA. Biomechanics of the Upper Extremity in Response to Dynamic Impact Loading Indicative of a Forward Fall: An Experimental and Numerical Investigation [PhD thesis]. University of Windsor; 2011.
1996	Milne AD, Chess DG, Johnson JA, King GJW. Accuracy of an electromagnetic tracking device: a study of the optimal operating range and metal interference. J Biomech. June 1996;29(6):791-793.
1998	Chiu J, Robinovitch SN. Prediction of upper extremity impact forces during falls on the outstretched hand. J Biomech. December 1998;31(12):1169-1176.
1994	Spadaro JA, Werner FW, Brenner RA, Fortino MD, Fay LA, Edwards WT. Cortical and trabecular bone contribute strength to the osteopenic distal radius. J Orthop Res. March 1994;12(2):211-218.
1997	Reinschmidt C, van den Bogert A, Nigg B, Lundberg A, Murphy N. Effect of skin movement on the analysis of skeletal knee joint motion during running. J Biomech. July 1997;30(7):729-732.
2013	Robinovitch SN, Feldman F, Yang Y, Schonnop R, Leung PM, Sarraf T, Sims-Gould J, Loughin M. Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study. Lancet. January 5, 2013;381(9860):47-54.
1998	Duda GN, Heller M, Albinger J, Schulz O, Schneider E, Claes L. Influence of muscle forces on femoral strain distribution. J Biomech. September 1998;31(9):841-846.
2010	Quenneville CE, Fraser GS, Dunning CE. Development of an apparatus to produce fractures from short-duration high-impulse loading with an application in the lower leg. J Biomech Eng. January 2010;132(1):014502.
1996	Yoganandan N, Pintar FA, Boynton M, Begeman P, Prasad P, Kuppa SM, Morgan RM, Eppinger RH. Dynamic axial tolerance of the human foot-ankle complex. In: Proceedings of the 40th Stapp Car Crash Conference. November 4-6, 1996; Albuquerque, NM. Warrendale, PA: Society of Automotive Engineers:207-218. SAE 962426.
1983	Horsman A, Currey JD. Estimation of mechanical properties of the distal radius from bone mineral content and cortical width. Clin Orthop Relat Res. June 1983;(176):298-304.

Year

Entry

2007

Cristofolini L, Juszczyk M, Martelli S, Taddei F, Viceconti M. In vitro replication of spontaneous fractures of the proximal human femur. J Biomech. 2007;40(13):2837-2845.

1998

Hsiao ET, Robinovitch SN. Common protective movements govern unexpected falls from standing height. J Biomech. January 1998;31(1):1-9.

2002

Funk JR, Crandall JR, Tourret LJ, MacMahon CB, Bass CR, Patrie JT, Khaewpong N, Eppinger RH. The axial injury tolerance of the human foot/ankle complex and the effect of Achilles tension. J Biomech Eng. 2002;124(6):750-757.

2007

Troy KL, Grabiner MD. Off-axis loads cause failure of the distal radius at lower magnitudes than axial loads: a finite element analysis. J Biomech. 2007;40(8):1670-1675.

2009

de Bakker PM, Manske SL, Ebacher V, Oxland TR, Cripton PA, Guy P. During sideways falls proximal femur fractures initiate in the superolateral cortex: evidence from high-speed video of simulated fractures. J Biomech. August 25, 2009;42(12):1917-1925.