Integrated iterative musculoskeletal modeling predicts bone morphology following brachial plexus birth injury (BPBI)
| Autor: | Katherine R. Saul, Jacqueline H. Cole, Daniel C. McFarland, Matthew B. Fisher, Nikhil N. Dixit |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Bone deformations
0206 medical engineering Biomedical Engineering Biophysics 02 engineering and technology Muscle mass Article 03 medical and health sciences 0302 clinical medicine Dorsal root ganglion Birth Injuries medicine Humans Orthopedics and Sports Medicine Brachial Plexus Brachial Plexus Neuropathies Child Bone growth Bone morphology business.industry Shoulder Joint Rehabilitation Anatomy Nerve injury medicine.disease 020601 biomedical engineering Birth injury Scapula medicine.anatomical_structure medicine.symptom business Brachial plexus 030217 neurology & neurosurgery |
| Zdroj: | J Biomech |
| Popis: | Brachial plexus birth injury (BPBI) is the most common nerve injury among children. The glenohumeral joint of affected children can undergo severe osseous deformation and altered muscle properties, depending on location of the injury relative to the dorsal root ganglion (preganglionic or postganglionic). Preganglionic injury results in lower muscle mass and shorter optimal muscle length compared to postganglionic injury. We investigated whether these changes to muscle properties over time following BPBI provide a mechanically-driven explanation for observed differences in bone deformity between preganglionic and postganglionic BPBI. We developed a computational framework integrating musculoskeletal modeling to represent muscle changes over time and finite element modeling to simulate bone growth in response to mechanical and biological stimuli. The simulations predicted that the net glenohumeral joint loads in the postganglionic injury case were nearly 10.5% greater than in preganglionic. Predicted bone deformations were more severe in the postganglionic case, with the glenoid more declined (pre: −43.8°, post: −51.0°), flatter with higher radius of curvature (pre: 3.0 mm, post: 3.7 mm), and anteverted (pre: 2.53°, post: 4.93°) than in the preganglionic case. These simulated glenoid deformations were consistent with previous experimental studies. Thus, we concluded that the differences in muscle mass and length between the preganglionic and postganglionic injuries are critical mechanical drivers of the altered glenohumeral joint shape. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|