Abstract
Background/PurposeFalls onto outstretched hands are the second most common sports injury and one of the leading causes of upper extremity injury. Injury risk and severity depends on forces being transmitted through the palmar surface to the upper extremity. Although the magnitude and distribution of forces depend on the soft tissue response of the palm, the in vivo properties of palmar tissue have not been characterized. The purpose of this study was to characterize the large deformation palmar soft tissue properties.MethodsIn vivo dynamic indentations were conducted on 15 young adults (21–29 years) to quantify the soft tissue characteristics of over the trapezium. The effects of loading rate, joint position, tissue thickness and sex on soft tissue responses were assessed.ResultsEnergy absorbed by the soft tissue and peak force were affected by loading rate and joint angle. Energy absorbed was 1.7–2.8 times higher and the peak force was 2–2.75 times higher at high rate loading than quasistatic rates. Males had greater energy absorbed than females but not at all wrist positions. Damping characteristics were the highest in the group with the thickest soft tissue while damping characteristics were the lowest in group with the thinnest soft tissues.ConclusionPalmar tissue response changes with joint position, loading rate, sex, and tissue thickness. Accurately capturing these tissue responses is important for developing effective simulations of fall and injury biomechanics and assessing the effectiveness of injury prevention strategies.
Highlights
Falls onto outstretched hands (FOOSH) are a leading cause of upper extremity injury
Energy absorbed by the soft tissue and peak force were affected by loading rate and joint angle
Palmar tissue response changes with joint position, loading rate, sex, and tissue thickness
Summary
Falls onto outstretched hands (FOOSH) are a leading cause of upper extremity injury. Upper extremities may be used to arrest a fall, which is useful for reducing injury to the head or torso [7, 8]; this results in the wrist being one of the most common injury sites after a fall [2, 9]. Computational models [14,15,16] and crash test dummies [17,18,19,20] are being used to simulate falls to quantify impact mechanics and define injury risk; these models are limited by a lack of accurate soft tissue properties. Characterizing the in vivo response of the palmar soft tissue will help us better simulate fall mechanics, quantify injury risk and identify opportunities for injury prevention
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