Clinical Biomechanics最新文献

The effects of actual and simulated visual impairments on the walking gait: A systematic review. 实际和模拟视觉障碍对步行步态的影响：系统综述。

IF 1.4 3区医学

Clinical Biomechanics Pub Date : 2026-05-03 DOI: 10.1016/j.clinbiomech.2026.106865

Michael Fish, Sean Hudson, Julia Bader, Rebekka Heitmar, Liane B Azevedo

{"title":"The effects of actual and simulated visual impairments on the walking gait: A systematic review.","authors":"Michael Fish, Sean Hudson, Julia Bader, Rebekka Heitmar, Liane B Azevedo","doi":"10.1016/j.clinbiomech.2026.106865","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2026.106865","url":null,"abstract":"<p><strong>Background: </strong>Visual impairments (VI) affect over 2.2 billion people worldwide and are linked to an increased risk of falls. To date, no reviews have systematically synthesised evidence for the effect of VI on whole body gait biomechanics, to better understand how different types of VI might affect gait.</p><p><strong>Methods: </strong>A systematic search up to July 2025 was conducted using PubMed (MEDLINE), Scopus, Web of Science, and ERIC. Eligible studies included adults, a diagnosed or simulated VI, a non-visually impaired comparator, and reported any of the following gait parameters: 1) Spatio-temporal; 2) Kinetics; 3) Kinematics; and 4) Muscle activity. Study quality was evaluated using quality assessment with diverse studies (QuADS) and a narrative synthesis undertaken (SWiM).</p><p><strong>Findings: </strong>Forty-four studies were included. Twenty-seven examined straight-line level walking, 12 examined obstacle walking and five examined both straight-line level and obstacle walking. Of those examining straight-line level walking, 12 simulated VI and 15 explored diagnosed VI's. In the obstacle walking literature, nine simulated VI and six included participants with diagnosed VI's. Inconsistent findings were common across studies, with most reporting either a more cautious gait strategy with VI, or no difference between VI and non-VI conditions.</p><p><strong>Interpretation: </strong>Differences between studies are likely explained by variation in gait measurement, non-standard VI simulation methods, and lack of detail surrounding the severity of diagnosis. This hinders provision of clinical recommendations based on existing evidence. We have proposed minimum reporting requirements around acuity, contrast sensitivity, visual field method/thresholds; simulation validation to facilitate clinical utilisation.</p>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"137 ","pages":"106865"},"PeriodicalIF":1.4,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ultrasonographic assessment of shoulder muscle thickness and isokinetic strength in patients with rotator cuff tendinopathy: A cross-sectional study. 肩袖肌腱病变患者肩肌厚度和等速力量的超声评估：一项横断面研究。

IF 1.4 3区医学

Clinical Biomechanics Pub Date : 2026-05-03 DOI: 10.1016/j.clinbiomech.2026.106866

Dilara Kara, Levent Özçakar, Taha İbrahim Yıldız, Serdar Demirci, Gazi Huri, İrem Düzgün

{"title":"Ultrasonographic assessment of shoulder muscle thickness and isokinetic strength in patients with rotator cuff tendinopathy: A cross-sectional study.","authors":"Dilara Kara, Levent Özçakar, Taha İbrahim Yıldız, Serdar Demirci, Gazi Huri, İrem Düzgün","doi":"10.1016/j.clinbiomech.2026.106866","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2026.106866","url":null,"abstract":"<p><strong>Background: </strong>Alterations in shoulder muscle thickness and strength are believed to be associated with rotator cuff (RC) tendinopathy. Previous studies have mainly focused on measuring the supraspinatus tendon thickness in relevant patients with shoulder pain. This study examined differences in shoulder muscle thickness and RC strength in the symptomatic and asymptomatic shoulders of patients with RC tendinopathy.</p><p><strong>Methods: </strong>Thirty-five patients with unilateral RC tendinopathy were included in this study. Muscle thickness of the supraspinatus, infraspinatus, deltoid, and combined middle trapezius+rhomboid was measured via ultrasonography, while RC strength (internal rotator [IR] and external rotator [ER]) at 60°/s and 180°/s was assessed using an isokinetic device.</p><p><strong>Findings: </strong>No significant differences were found in muscle thickness (supraspinatus p = .342; infraspinatus, p = .746; deltoid p = .112; middle trapezius+rhomboid, p = .378), RC strength (ER 60°/s p = .283; IR 60°/s p = .337; ER 180°/s p = .334; IR 180°/s p = .141), or ER/IR strength ratios (60°/s p = .857; 180°/s p = .379) between symptomatic and asymptomatic shoulders. Significant correlations ranging from weak-to-high were found between supraspinatus, infraspinatus, and deltoid thickness and RC strength (r = 0.354-0.732, p < .05). A moderate correlation was observed between middle trapezius+rhomboid thickness and shoulder ER strength (r = 0.620-0.625, p < .001), but no correlation with IR strength (p > .05).</p><p><strong>Interpretation: </strong>Patients with RC tendinopathy exhibited similar shoulder muscle thickness, ER and IR strength, and ER/IR strength ratios between symptomatic vs. asymptomatic shoulders. Additionally, shoulder muscle thickness appears to be associated with shoulder rotator strength.</p>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"137 ","pages":"106866"},"PeriodicalIF":1.4,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Biomechanical evaluation of humeral torsional strength following biceps tenodesis: A cadaveric study. 肱二头肌肌腱固定术后肱骨扭转强度的生物力学评价：尸体研究。

IF 1.4 3区医学

Clinical Biomechanics Pub Date : 2026-05-01 DOI: 10.1016/j.clinbiomech.2026.106857

Graham E Sullivan, Julia N Zuppke, Nicholas Erdle, Erika Dopson, James Hammond, Christopher Smith

{"title":"Biomechanical evaluation of humeral torsional strength following biceps tenodesis: A cadaveric study.","authors":"Graham E Sullivan, Julia N Zuppke, Nicholas Erdle, Erika Dopson, James Hammond, Christopher Smith","doi":"10.1016/j.clinbiomech.2026.106857","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2026.106857","url":null,"abstract":"<p><strong>Background: </strong>Humerus fractures are a known and devastating complication of subpectoral biceps tenodesis. The purpose of this study is to compare the torsional failure strength of the humerus after subpectoral biceps tenodesis using three fixation methods: unicortical button, interference screw, and all-suture anchor.</p><p><strong>Methods: </strong>Thirty matched pairs of cadaveric humeri were randomized into three study arms (ten pairs each): interference screw versus unicortical button, interference screw versus all-suture anchor, and unicortical button versus all-suture anchor. Torsional loads to failure were applied to the cadavers using a MTS Bionix tabletop system. Maximum torque, degree of rotation to failure, and torsional stiffness were compared using paired t-tests.</p><p><strong>Findings: </strong>Unicortical button fixation exhibited significantly higher maximum torque at failure compared to both interference screw (41.86 N.m ± 13.20 N.m to 29.81 N.m ± 9.47 N.m) and suture anchor (39.13 N.m ± 16.65 N.m to 30.90 N.m ± 18.31 N.m) fixation. There was no significant difference in maximum torque between interference screw and suture anchor (31.67 N.m ± 13.43 N.m to 30.39 N.m ± 13.31 N.m). No significant differences were observed in the degree of rotation or stiffness in any of the three study arms.</p><p><strong>Interpretation: </strong>Unicortical button fixation offers superior resistance to torsional forces and humerus fracture compared to interference screw and all-suture anchor fixation techniques in subpectoral biceps tenodesis. This information could help surgeons make choices for implants to minimize complications and better educate their patients on potential outcomes.</p>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"137 ","pages":"106857"},"PeriodicalIF":1.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Restraining effect of the newly developed elastomeric knee brace for anterior cruciate ligament-deficient knees using anterior displacement model 新研制的弹性膝支具对前交叉韧带缺损膝关节的抑制作用。

IF 1.4 3区医学

Clinical Biomechanics Pub Date : 2026-04-01 Epub Date: 2026-02-05 DOI: 10.1016/j.clinbiomech.2026.106781

Junpil Song , Maki Koyanagi , Satoshi Morishita , Kouichi Mukai , Yoshiatsu Ikegami , Kai Hirata , Kazuhiko Nakano

{"title":"Restraining effect of the newly developed elastomeric knee brace for anterior cruciate ligament-deficient knees using anterior displacement model","authors":"Junpil Song , Maki Koyanagi , Satoshi Morishita , Kouichi Mukai , Yoshiatsu Ikegami , Kai Hirata , Kazuhiko Nakano","doi":"10.1016/j.clinbiomech.2026.106781","DOIUrl":"10.1016/j.clinbiomech.2026.106781","url":null,"abstract":"<div><h3>Background</h3><div>Knee braces are often prescribed for individuals with anterior cruciate ligament-deficient knees. Although rigid functional knee braces are limited to certain contact sports, soft knee braces can be used in almost all sports. However, few studies have investigated the restraining effect of soft knee braces. We developed an elastomeric knee brace with anatomical straps and no rigid hinges to improve its suitability for athletic use. This study aimed to investigate the restraining force of the elastomeric brace and compare it with that of functional and soft braces.</div></div><div><h3>Methods</h3><div>A custom-made anterior displacement knee model was used. The restraining force of the elastomeric, functional, and soft braces against 20 mm of anterior tibial displacement was measured in five sets of five repetitions using a tensile testing machine directly connected to the knee model.</div></div><div><h3>Findings</h3><div>The elastomeric knee brace demonstrated a higher restraining force at all displacements than the functional and soft knee braces, particularly in the initial phase (0–10 mm). The decrease in the restraining force over repeated trials was less pronounced at 5- and 10-mm displacements, indicating that the elastomeric knee brace maintained a more stable restraining force.</div></div><div><h3>Interpretation</h3><div>The developed elastomeric knee brace exerted a higher restraining force against anterior tibial displacement than the functional and soft knee braces, and this restraining effect was maintained even after repeated use.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106781"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Six-week biofeedback gait retraining programme for people with knee osteoarthritis: A randomised controlled trial 膝骨关节炎患者六周生物反馈步态再训练计划：一项随机对照试验。

IF 1.4 3区医学

Clinical Biomechanics Pub Date : 2026-04-01 Epub Date: 2026-02-07 DOI: 10.1016/j.clinbiomech.2026.106776

Yi Wan , Polly McGuigan , James Bilzon , Logan Wade

{"title":"Six-week biofeedback gait retraining programme for people with knee osteoarthritis: A randomised controlled trial","authors":"Yi Wan , Polly McGuigan , James Bilzon , Logan Wade","doi":"10.1016/j.clinbiomech.2026.106776","DOIUrl":"10.1016/j.clinbiomech.2026.106776","url":null,"abstract":"<div><h3>Background</h3><div>Knee osteoarthritis causes pain, can limits mobility and is linked to excessive knee loading. Gait retraining with biofeedback shows promise in reducing knee loading and improving pain and function, but optimal feedback strategies remain unclear. This study compared the effects of different biofeedback-based gait retraining approaches on knee joint loading, pain and functional outcomes.</div></div><div><h3>Methods</h3><div>Fifty individuals with knee osteoarthritis were randomised to gait pattern feedback group, knee moment feedback group, or control group. Participants underwent a six-week programme, with activity knee pain, functional ability and biomechanical assessments conducted at baseline, post-intervention, and one-month follow-up. Data were analysed using linear mixed models under an intention-to-treat approach.</div></div><div><h3>Findings</h3><div>All groups improved in functional ability and activity knee pain post-intervention (<em>p</em> < 0.001), with sustained benefits in the intervention groups (p < 0.001). Only the gait pattern group showed a lasting reduction in the 1st peak knee adduction moment during (−7.6%, <em>p</em> = 0.003; maintained at follow-up). No significant change in foot progression angle was observed in any group. Step width increased during stair ascent and sit-to-stand (<em>p</em> ≤ 0.010) and step length decreased during walking (<em>p</em> = 0.021) for all groups, but both changes were transient.</div></div><div><h3>Interpretation</h3><div>Gait retraining improves pain and function in individuals with knee OA, but gait pattern feedback uniquely reduces joint loading during walking, supporting the importance of target-specific personalised gait modifications for long-term biomechanical benefit.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106776"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Soft tissue injuries induce lumbar instability and intervertebral disc degeneration: A mechanobiological study based on a rabbit model 软组织损伤诱导腰椎不稳定和椎间盘退变：基于兔模型的力学生物学研究。

IF 1.4 3区医学

Clinical Biomechanics Pub Date : 2026-04-01 Epub Date: 2026-02-05 DOI: 10.1016/j.clinbiomech.2026.106773

Pengren Luo , Jiawen Zhan , Boyu Zhang , Pingjin Xie , Pengchao Zhen , Zhefeng Jin , Tao Han , Liguo Zhu

{"title":"Soft tissue injuries induce lumbar instability and intervertebral disc degeneration: A mechanobiological study based on a rabbit model","authors":"Pengren Luo , Jiawen Zhan , Boyu Zhang , Pingjin Xie , Pengchao Zhen , Zhefeng Jin , Tao Han , Liguo Zhu","doi":"10.1016/j.clinbiomech.2026.106773","DOIUrl":"10.1016/j.clinbiomech.2026.106773","url":null,"abstract":"<div><h3>Background</h3><div>Lumbar instability, often associated with intervertebral disc degeneration, is a key contributor to chronic low back pain. However, the mechanobiological interplay between soft tissue injury and the onset of spinal instability remains poorly elucidated.This study aimed to develop and characterize a rabbit model of lumbar instability based on endogenous (ligamentous) and exogenous (muscular) soft tissue injuries, and to investigate the biomechanical and biological progression of intervertebral disc degeneration over time.</div></div><div><h3>Methods</h3><div>Fifty-four New Zealand white rabbits were randomly assigned to three groups: endogenous ligament injury, exogenous muscle injury, and control. Multiple evaluation methods—including X-ray imaging, finite element analysis, creep and fatigue testing, histological staining, TUNEL apoptosis detection, and Western blotting for Aggrecan, Collagen II, and Caspase-3—were conducted at 0, 4, 8, 16, and 24 weeks post-modeling.</div></div><div><h3>Findings</h3><div>Both injury models led to progressive lumbar instability and intervertebral disc degeneration, evidenced by decreased disc elasticity, increased displacement under load, and structural deterioration in imaging and histology. FEA revealed altered stress distribution and increased mechanical burden over time. Aggrecan and Collagen II expression significantly declined, while Caspase-3 levels and TUNEL-positive apoptotic cells increased, especially in the exogenous group.</div></div><div><h3>Interpretation</h3><div>Muscle and ligament injuries are sufficient to induce lumbar instability and promote progressive disc degeneration through biomechanical failure and apoptosis. These findings underscore the importance of early mechanical and biological interventions targeting soft tissue integrity to prevent intervertebral disc degeneration and lumbar instability.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106773"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Upper and lower trunk accelerometer-based metrics during gait as predictors of physical function in older adults 基于上肢和下肢加速度计的步态指标作为老年人身体功能的预测指标。

IF 1.4 3区医学

Clinical Biomechanics Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1016/j.clinbiomech.2026.106774

Takahiro Oki , Keiko Yamada , Shigeru Nada , Ryoki Nishimoto , Sayaka Fujiwara , Toru Ogata

{"title":"Upper and lower trunk accelerometer-based metrics during gait as predictors of physical function in older adults","authors":"Takahiro Oki , Keiko Yamada , Shigeru Nada , Ryoki Nishimoto , Sayaka Fujiwara , Toru Ogata","doi":"10.1016/j.clinbiomech.2026.106774","DOIUrl":"10.1016/j.clinbiomech.2026.106774","url":null,"abstract":"<div><h3>Background</h3><div>Physical function and activities of daily living (ADLs) are key determinants of independence in older adults, with walking being an essential component of ADLs. Gait assessment using multiple sensors may enable early detection of functional decline and cause-specific intervention. We hypothesized that specific accelerometer-based gait metrics from both the upper and lower trunk sensors are associated with declining mobility in older adults.</div></div><div><h3>Methods</h3><div>Gait analysis was conducted in community-dwelling older adults with declining mobility using accelerometers attached to the upper and lower trunk. Physical function was evaluated using the five-repetition sit-to-stand test, single-leg standing time, three-meter Timed Up and Go test, preferred gait speed, and the locomotive syndrome risk test. Associations between physical performance and accelerometer-based metrics were examined using correlation, regression, and principal component analyses.</div></div><div><h3>Findings</h3><div>Gait speed correlated strongly with Root Mean Square (RMS)-vertical (VT) and with several performance metrics. Upper RMS-VT, upper improved Harmonic Ratio in the anteroposterior direction (iHR-AP), upper iHR-VT, lower iHR-AP, and the upper/lower trunk RMS ratio in the mediolateral direction ([U/L] RMS ratio-ML) associated with performance metrics. After adjustment for age, sex, and gait speed, upper and lower iHR-AP and upper iHR-VT remained associated (<em>p</em> < 0.05). Principal component analysis indicated that principal component 1, which was correlated with gait speed, included RMS-VT, whereas iHRs belonged to a different component.</div></div><div><h3>Interpretation</h3><div>Accelerometer-based metrics obtained from both the upper and lower trunk reflect physical function and may serve as indicators of early gait impairment, as well as for future interventional studies.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106774"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predicting gait kinetics using 3-degrees of freedom acceleration data and artificial neural networks 利用三自由度加速度数据和人工神经网络预测步态动力学

IF 1.4 3区医学

Clinical Biomechanics Pub Date : 2026-04-01 Epub Date: 2026-01-31 DOI: 10.1016/j.clinbiomech.2026.106775

Carina Gempfer , Gilmar F. Santos , Alexander Hobein , Timo Kuhlgatz , Christof Hurschler , Eike Jakubowitz

{"title":"Predicting gait kinetics using 3-degrees of freedom acceleration data and artificial neural networks","authors":"Carina Gempfer , Gilmar F. Santos , Alexander Hobein , Timo Kuhlgatz , Christof Hurschler , Eike Jakubowitz","doi":"10.1016/j.clinbiomech.2026.106775","DOIUrl":"10.1016/j.clinbiomech.2026.106775","url":null,"abstract":"<div><h3>Background</h3><div>Motion analysis plays an important role in clinical decision-making and biomechanical research. Conventional assessments rely on laboratory-based motion capture and force plates, which are accurate but resource-intensive. Wearable sensors combined with artificial neural networks offer a promising alternative for use outside the laboratory, but they must be validated against established systems. The aim of this study was to predict important kinetic gait parameters, such as ground reaction forces, knee joint moments and knee power, using wearable sensors and neural networks. Such an approach may support gait assessment in orthopaedic conditions and enable more responsive adjustment of exoprostheses.</div></div><div><h3>Methods</h3><div>Thirty-two healthy adults provided informed consent and were instrumented. Standard kinematic and kinetic data were captured using a conventional motion analysis setup, while linear accelerations were recorded synchronously using wearable sensors. These acceleration signals were used as inputs for two neural network models (long short-term memory and multilayer perceptron) to predict kinetic parameters.</div></div><div><h3>Findings</h3><div>Both models achieved good to very good agreement with the reference system. Pearson correlation coefficients ranged from 0.79 for the knee joint power to 0.99 for anteroposterior ground reaction force. The normalised root mean square errors between 3.1% and 10.3% further demonstrated promising predictive accuracy.</div></div><div><h3>Interpretation</h3><div>The findings indicate that wearable sensors combined with neural networks can estimate clinically relevant kinetic gait parameters with high accuracy outside a laboratory setting. In the future, such predictions may help standardize dynamic adjustments of exoprostheses, support the diagnosis of orthopaedic conditions and evaluate treatment outcomes.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106775"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146122563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Micromotion at a femoral osteotomy stabilized with a retrograde interlocking intramedullary nail 用逆行交锁髓内钉稳定股骨截骨术中的微动

IF 1.4 3区医学

Clinical Biomechanics Pub Date : 2026-04-01 Epub Date: 2026-01-17 DOI: 10.1016/j.clinbiomech.2026.106749

Rachel L. Lenhart , Mei Wang , Gregory J. Schmeling

{"title":"Micromotion at a femoral osteotomy stabilized with a retrograde interlocking intramedullary nail","authors":"Rachel L. Lenhart , Mei Wang , Gregory J. Schmeling","doi":"10.1016/j.clinbiomech.2026.106749","DOIUrl":"10.1016/j.clinbiomech.2026.106749","url":null,"abstract":"<div><h3>Background</h3><div>Retrograde nails are becoming used increasingly in the trauma setting and the indications are expanding. The goal of this study was to evaluate micromotion at fracture sites in the proximal half of the femur stabilized with a retrograde intramedullary nail to determine the effects of fracture location, canal fill, and screw configuration.</div></div><div><h3>Methods</h3><div>Composite femurs were loaded in simulated single-leg stance while measurements of micromotion were made using linear variable differential transducers and motion analysis. Part one of the study compared differences by fracture location (subtrochanteric vs. proximal third vs. mid-shaft). Part two determined the effects of canal fill (13 vs. 10 mm nail) and proximal interlocking screw configuration on micromotion in the setting of subtrochanteric fracture.</div></div><div><h3>Findings</h3><div>Subtrochanteric fracture location led to significantly more axial displacement compared to the other locations (<em>p</em> < 0.05). Reduced canal fill led to more coronal rotation (p < 0.05) and likely more axial displacement (<em>p</em> = 0.06). Screw configuration was important for axial displacement (<em>p</em> < 0.05), particularly in the non-canal filling condition where the proximal screw configuration with only one screw in the more proximal location had increased micromotion compared to one distal.</div></div><div><h3>Interpretation</h3><div>Fracture location, nail size, and proximal locking screw configuration are all important to the stability of the fracture construct. In subtrochanteric fractures, surgeons should consider using a canal filling nail with either two screws or the distal screw only, or using a different nail design.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106749"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146122562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Threshold screw insertion torque for carbon fibre-reinforced polyetheretherketone and titanium (Ti-6Al-4V) locking plate constructs 碳纤维增强聚醚醚酮和钛（Ti-6Al-4V）锁定板结构的阈值螺钉插入扭矩。

IF 1.4 3区医学

Clinical Biomechanics Pub Date : 2026-04-01 Epub Date: 2026-01-22 DOI: 10.1016/j.clinbiomech.2026.106769

Ramzi Nasr , Elise Pegg , Fedra Zaribaf , James Fletcher

{"title":"Threshold screw insertion torque for carbon fibre-reinforced polyetheretherketone and titanium (Ti-6Al-4V) locking plate constructs","authors":"Ramzi Nasr , Elise Pegg , Fedra Zaribaf , James Fletcher","doi":"10.1016/j.clinbiomech.2026.106769","DOIUrl":"10.1016/j.clinbiomech.2026.106769","url":null,"abstract":"<div><h3>Background</h3><div>Locking plate constructs are integral to modern fracture fixation, particularly in osteoporotic bone. Carbon-fibre reinforced polyetheretherketone (CFR-PEEK) plates offer a stiffness profile closer to cortical bone than titanium, potentially improving the mechanical environment for healing. However, the optimal insertion torque for locking screws in CFR-PEEK plates is unclear. This study investigated the influence of insertion torque on construct performance in CFR-PEEK plates compared to titanium alloy (Ti-6Al-4V) plates.</div></div><div><h3>Methods</h3><div>Locking screws (3.5 mm, Ti-6Al-4V) were inserted into Ti-6Al-4V and CFR-PEEK plates at six torque levels (0.5–3.0 Nm). Construct strength was assessed via axial push-out and cantilever bending tests. Video analysis was used to correlate insertion torque with screw rotation. Additional testing was performed on two-screw CFR-PEEK constructs at three torque levels (0.5, 1.5, 2.5 Nm).</div></div><div><h3>Findings</h3><div>Insertion torque was linearly related to screw rotation within the tested range (0.5–3.0 Nm). In CFR-PEEK single screw constructs, higher torque (≥2 Nm) improved push-out strength (<em>p</em> < 0.05), while 1.5 Nm yielded the highest cantilever strength (p < 0.05). Ti-6Al-4V constructs showed a similar trend. In two-screw CFR-PEEK constructs, no significant differences were found in performance across torques for either push-out or cantilever testing (<em>p</em> > 0.5).</div></div><div><h3>Interpretation</h3><div>Beyond an initial threshold (∼0.5 Nm), increased insertion torque did not consistently enhance construct performance. These findings indicate that moderate torques (∼1.5 Nm) optimise performance while reducing the risk of implant damage, support the mechanical reliability of CFR-PEEK plates.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"134 ","pages":"Article 106769"},"PeriodicalIF":1.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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