Biomechanical analysis of sport induced hamate stress fractures

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-05-21 DOI:10.1016/j.clinbiomech.2025.106567

Andrzej Jasina , Sina Gräber , Parisa Pourostad , Volker Schöffl , Magdalena Wagner , Thomas Bayer , Sabine Ohlmeyer , Michael Simon , Christoph Lutter

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引用次数: 0

Abstract

Background

Bouldering is known for a high risk of hamate injuries. Over 75 % of sport climbers have signs of upper extremity overuse injuries. Training overload corresponds with bone edema and was linked to fractures of the hamate. To date, no study has addressed the pathomechanism of hamate fracture in climbing. The aim of this study was to investigate the stability of the hamate in a biomechanical setup under the tension of the flexor tendons.

Methods

20 fresh-frozen, unfixed human forearms were used for two test series. The test stand consisted of an modified isokinet. Tension was applied by a motor. The specimens were prepared and positioned in ulnar deviation for the first test series. Additionally, the flexor tendons of the specimens were replaced by a steel cable in the anatomical course for the second series.

Findings

In the first series, no fracture occurred at the hamate. Causes for termination of these measurements were tendon rupture and failure of the suture in majority of the cases. In the second setup, tension was applied to the cable with an average maximum force of 1029.4 N [105 kg]. Fracture of the hamate occurred in two out of ten cases. The mean force measured in those cases was 1008.30 N [102.8 kg].

Interpretation

Our results shows that it is possible for flexor tendon's tensile load to cause hamate fracture. It must be considered in patients with ulnar localized pain in the wrist, especially with a suitable sports history. Its quick diagnosis allows further therapy and rehabilitation to be initiated.

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运动诱发钩骨应力性骨折的生物力学分析

众所周知，抱石是一种高风险的运动。超过75%的运动攀岩者有上肢过度使用损伤的迹象。训练负荷与骨水肿相对应，并与钩骨骨折有关。到目前为止，还没有研究解决攀岩中钩骨骨折的病理机制。本研究的目的是研究在屈肌腱张力下生物力学装置中钩骨的稳定性。方法用20只新鲜冷冻、未固定的人前臂进行两组试验。试验台由一个改进型的isoinet组成。张力是由马达施加的。在第一个测试系列中，准备好标本并将其定位于尺侧偏差。此外，在第二个系列的解剖过程中，用钢索代替了标本的屈肌腱。在第一个系列中，钩骨未发生骨折。在大多数情况下，终止这些测量的原因是肌腱断裂和缝合失败。在第二次设置中，张力被施加到电缆上，平均最大力为1029.4 N [105 kg]。10例中有2例发生钩骨骨折。在这些病例中测得的平均力为1008.30 N [102.8 kg]。我们的研究结果表明，屈肌腱的拉伸载荷可能导致钩骨骨折。对于腕部尺侧局部疼痛的患者，尤其是有合适运动史的患者，必须考虑到这一点。它的快速诊断允许进一步的治疗和康复开始。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.