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General Orthopaedics

PHYSICAL SIMULATION OF THE INTEROSSEOUS LIGAMENTS DURING FOREARM ROTATION

International Society of Computer-Assisted Orthopaedic Surgery (CAOS), 17th Annual Scientific Meeting, Aachen, June 2017



Abstract

The Interosseous Membrane (IOM) of the forearm is made up of ligaments, which are involved in load balancing of the radioulnar joint and the shaft. Motion models of the forearm are necessary for planning orthopedic surgeries, such as osteotomies, which aim at solving limit of the range of motion or instabilities. However, existing models focus on a pure kinematic approach, omitting the physical properties of the ligaments, thus limiting the range of application by missing dynamical effects.

We developed a model that takes into account the mechanical properties of the IOM. We simulated the pro-supination by creating an elastic coupling to the desired motion around the standard axis of rotation. We tested our model on a healthy subject, using CT-reconstructed bone models, and literature data for the ligaments. Multiple parameters, including forces of ligaments and positions of landmarks, are output for analysis.

The length of the ligaments over pro-supination was in agreement with the literature. Their rest lengths must be recorded in future anatomical studies. The IOM helps in maintaining the contact with cartilage, except in late pronation. Scarring of the central band increases the force generated along the axis of rotation toward the wrist, while scarring of the proximal part does the opposite in pronation.

In contrast to kinematic models, the proposed model is helpful to study the effect of physical properties of the IOM, such scarring, on the forearm motion. Future work will be to apply our model to pathological cases, and to compare to clinical observations.