BIOMECHANICS OF THE HUMANFOREARM IN HEALTH AND DISEASE

Abstract

Introduction:The forearm is a complex biological unit, which has allowed man'sevolution. This PhD commenced with an analysis of the normal biomechanicalfunctioning of the key components of the forearm: notably the distal radioulnarjoint (DRUJ), interosseous ligament (IOL) and proximal radioulnar joint (PRUJ).Understanding normal forearm physiology, a clinical study followed to delineatethe pathophysiology of a new clinical entity, related to DRUJ dysfunction.Methods:BIOMECHANICAL STUDY: A biomechanical testing jig was developed tofacilitate collection of data about normal functioning of the DRUJ, IOL andPRUJ in both unloaded and loaded states. This permitted testing throughoutthe range of forearm pronosupination. Thawed fresh frozen cadaveric upperlimbs were mounted into the jig. Using Microstrain® strain gauges andTekscan pressure sensors, the functional anatomy of the key components ofthe forearm was delineated, both with the forearm flexed at 90° and maximallyextended at the elbow.CLINICAL STUDY: A series of 3-Tesla MRI scans was undertaken on patientssymptomatic of an intermittent ulnar neuropathy. The causative pathophysiologywas determined using 3D qualitative and quantitative analyses.ResultsBIOMECHANICAL STUDY: Reproducible patterns of force transmitted and jointcontact area have been determined for the DRUJ, and for the first time, thePRUJ. With the exception of PMax and P60 for the PRUJ, application of loadincreases contact areas and transmitted forces across the joints (P

Date of Award	31 Dec 2012
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Vivien Lees (Supervisor) & Giorgio Terenghi (Supervisor)