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Journal article
The Biomechanical Basis of the Claw Finger Deformity: A Computational Simulation Study
The Journal of hand surgery (American ed.), v 44(9), pp 751-761
01 Sep 2019
PMID: 31248678
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose Claw finger deformity occurs during attempted finger extension in patients whose intrinsic finger muscles are weakened or paralyzed by neural impairments. The deformity is generally not acutely present after intrinsic muscle palsy. The delayed onset, with severity progressing over time, suggests soft tissue changes that affect the passive biomechanics of the hand exacerbate and advance the deformity. Clinical interventions may be more effective if such secondary biomechanical changes are effectively addressed. Using a computational model, we simulated these altered soft tissue biomechanical properties to quantify their effects on coordinated finger extension.
Methods To evaluate the effects of maladaptive changes in soft tissue biomechanical properties on the development and progression of the claw finger deformity after intrinsic muscle palsy, we completed 45 biomechanical simulations of cyclic index finger flexion and extension, varying the muscle excitation level, clinically relevant biomechanical factors, and wrist position. We evaluated to what extent (1) increased joint laxity, (2) decreased mechanical advantage of the extensors about the proximal interphalangeal joint, and (3) shortening of the flexor muscles contributed to the development of claw finger deformity in an intrinsic-minus hand model.
Results Of the mechanisms studied, shortening (or contracture) of the extrinsic finger flexors was the factor most associated with the development of claw finger deformity in simulation.
Conclusions These simulations suggest that adaptive shortening of the extrinsic finger flexors is required for the development of claw finger deformity. Increased joint laxity and decreased extensor mechanical advantage only contributed to the severity of the deformity in simulations when shortening of the flexor muscles was present. Copyright (C) 2019 by the American Society for Surgery of the Hand. All rights reserved.)
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Details
- Title
- The Biomechanical Basis of the Claw Finger Deformity: A Computational Simulation Study
- Creators
- Benjamin I. Binder-Markey - Northwestern UniversityJulius P. A. Dewald - Northwestern UniversityWendy M. Murray - Northwestern University
- Publication Details
- The Journal of hand surgery (American ed.), v 44(9), pp 751-761
- Publisher
- Elsevier
- Number of pages
- 11
- Grant note
- T32EB009406; R01HD084009 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Promotion of Doctoral Studiese Level II Scholarship from the Foundation for Physical Therapy R01HD084009 / EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) 16PRE30970010 / American Heart Association-Pre-Doctoral Fellowship; American Heart Association T32EB009406 / NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Biomedical Imaging & Bioengineering (NIBIB)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Physical Therapy (and Rehabilitation Sciences)
- Web of Science ID
- WOS:000483916200005
- Scopus ID
- 2-s2.0-85067640816
- Other Identifier
- 991021855265004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Orthopedics
- Surgery