Distal Interphalangeal Joint Angles Research Articles

Changes in aspects of hoof and distal limb conformation in foals by radiographic evaluation.

This study investigated age-related radiographic changes in the distal parts of the forelimbs by radiographic evaluation and identified the radiographic changes associated with diseases specific to foals. The hoof angle (HA), distal phalanx angle (P3A), distal phalanx palmer angle (P3PA), distal interphalangeal joint angle (DIPJA), and metacarpophalangeal joint angle (MPJA) on lateromedial radiographs of forelimbs were measured on the day after birth (Day 1); at 1, 2, 4, 6, and 8 weeks of age; and then at monthly intervals until 12 months of age. HA and P3A significantly increased from 1 day to 4 weeks and 4 weeks to 3 months of age. The P3PA increased dramatically from 1 day to 1 week, 1 week to 2 weeks, and 2 weeks to 8 weeks of age, and then decreased after 3 months of age. DIPJA significantly decreased from 1 day to 2 weeks of age before increasing from 3 to 5 months of age. MPJA increased with age until 4 weeks, slightly decreased from 2 to 4 months of age, and then gradually decreased from 4 to 6 months of age. The findings indicate that foals' forelimbs typically show flexion of the fetlock and a broken backward hoof-pastern axis just after birth, an upright fetlock until 4 months of age, and a change to a mature conformation after 6 months of age. Physiological variants were correlated with the occurrence of common foal diseases during the radiographic evaluation periods.

Biomimetic Tendon-Based Mechanism for Finger Flexion and Extension in a Soft Hand Exoskeleton: Design and Experimental Assessment.

This study proposes a bioinspired exotendon routing configuration for a tendon-based mechanism to provide finger flexion and extension that utilizes a single motor to reduce the complexity of the system. The configuration was primarily inspired by the extrinsic muscle-tendon units of the human musculoskeletal system. The function of the intrinsic muscle-tendon units was partially compensated by adding a minor modification to the configuration of the extrinsic units. The finger kinematics produced by this solution during flexion and extension were experimentally evaluated on an artificial finger and compared to that obtained using the traditional mechanism, where one exotendon was inserted at the distal phalanx. The experiments were conducted on nine healthy subjects who wore a soft exoskeleton glove equipped with the novel tendon mechanism. Contrary to the traditional approach, the proposed mechanism successfully prevented the hyperextension of the distal interphalangeal (DIP) and the metacarpophalangeal (MCP) joints. During flexion, the DIP joint angles produced by the novel mechanism were smaller than the angles generated by the traditional approach for the same proximal interphalangeal (PIP) joint angles. This provided a flexion trajectory closer to the voluntary flexion motion and avoided straining the interphalangeal coupling between the DIP and PIP joints. Finally, the proposed solution generated similar trajectories when applied to a stiff artificial finger (simulating spasticity). The results, therefore, demonstrate that the proposed approach is indeed an effective solution for the envisioned soft hand exoskeleton system.

Evaluating the long-term conformation and hoof growth effects of starting hoof trimming at 5 months of age in New Zealand dairy goats

Hoof overgrowth is associated with poor conformation, an altered weight-bearing surface, and a reduction in the hoof's anatomic and functional integrity. As a result of housing systems that promote hoof overgrowth, hoof trimming is considered a priority in dairy goats. However, there are few data on the effects of the timing of first trimming on hoof conformation and growth rate. The aims of this study were (1) to evaluate the long-term effects of 2 different hoof trimming start times and (2) to investigate the pattern of hoof growth across the first 2 yr of life. Eighty 5-mo-old female Saanen-cross commercially housed dairy goats were allocated randomly to 1 of 2 treatments: (1) early trimmed (trimming beginning at 5 mo old; hooves were trimmed every 4 mo thereafter) and (2) late trimmed (trimming beginning at 13 mo old; hooves were trimmed every 4 mo thereafter). Using a combination of photographs and radiographs, hoof conformation, joint positions, and hoof wall length were assessed before the 13- and 25-mo trimming events. Hoof growth was assessed every 12 wk using caliper measurements. Overall, starting hoof trimming earlier had minor and inconsistent effects. However, detrimental changes in conformation and joint positions occurred between trimming events, particularly in the hind hooves, regardless of trimming treatment. At both assessments, there was a high percentage of overgrown toes and dipped heels, with the hind hooves being more affected compared with the front (overgrown toes at 13 mo, 97.1 vs. 79.1 ± 5.2%; overgrown toes at 25 mo, 91.7 vs. 56.3 ± 6.7%; dipped heels at 13 mo, 98.5 vs. 19.3 ± 5.0%; dipped heels at 25 mo, 88.3 vs. 4.9 ± 4.8%). In addition, at both assessments, the distal interphalangeal joint angle was greater in the hind hooves compared with the front (13 mo, 79.5 vs. 65.2 ± 1.7°; 25 mo, 79.0 vs. 66.7 ± 0.9°), whereas heel angles were less in the hind hooves compared with the front (13 mo, 41.8 vs. 57.1 ± 1.5°; 25 mo, 44.9 vs. 55.9 ± 1.1°). On average, the front hooves grew 4.39 mm/mo and the hind hooves grew 4.20 mm/mo. Early trimming did not have consistent effects on hoof growth rate. Importantly, our results suggest that trimming every 4 mo is not sufficient to prevent hoof overgrowth, the development of poor conformation, and detrimental changes in joint positions, particularly in the hind hooves. Furthermore, the detrimental changes may have masked any long-term treatment effects. Therefore, trimming frequency and age of first trimming should be considered when devising hoof care protocols for dairy goats housed in environments that do not offer opportunities for natural hoof wear.

Studying kinematic linkage of finger joints: estimation of kinematics of distal interphalangeal joints during manipulation.

The recording of hand kinematics during product manipulation is challenging, and certain degrees of freedom such as distal interphalangeal (DIP) joints are difficult to record owing to limitations of the motion capture systems used. DIP joint kinematics could be estimated by taking advantage of its kinematic linkage with proximal interphalangeal (PIP) and metacarpophalangeal joints. This work analyses this linkage both in free motion conditions and during the performance of 26 activities of daily living. We have studied the appropriateness of different types of linear regressions (several combinations of independent variables and constant coefficients) and sets of data (free motion and manipulation data) to obtain equations to estimate DIP joints kinematics both in free motion and manipulation conditions. Errors that arise when estimating DIP joint angles assuming linear relationships using the equations obtained both from free motion data and from manipulation data are compared for each activity of daily living performed. Estimation using manipulation condition equations implies a lower mean absolute error per task (from 5.87° to 13.67°) than using the free motion ones (from 9° to 17.87°), but it fails to provide accurate estimations when passive extension of DIP joints occurs while PIP is flexed. This work provides evidence showing that estimating DIP joint angles is only recommended when studying free motion or grasps where both joints are highly flexed and when using linear relationships that consider only PIP joint angles.

Biomechanical and musculoskeletal changes after flexor tenotomy to reduce the risk of diabetic neuropathic toe ulcer recurrence.

ObjectiveTo assess the effect of flexor tenotomy in patients with diabetes on barefoot plantar pressure, toe joint angles and ulcer recurrence during patient follow‐up.MethodsPatients with a history of ulceration on the toe apex were included. They underwent minimally invasive needle flexor tenotomy by an experienced musculoskeletal surgeon. Dynamic barefoot plantar pressure measurements and static weight‐bearing radiographs were taken before and 2–4 weeks after the procedure.ResultsA total of 14 patients underwent flexor tenotomy on 50 toes in 19 feet. There was a mean follow‐up time of 11.4 months. No ulcer recurrence occurred during follow‐up. Mean barefoot plantar pressure was assessed on 34 toes and decreased significantly after the procedure by a mean 279 kPa (95% CI: 204–353; p < 0.001). Metatarsophalangeal, proximal interphalangeal and distal interphalangeal joint angles were assessed on nine toes and all decreased significantly (by 7° [95% CI: 4–9; p < 0.001], 19° [95% CI: 11–26; p < 0.001] and 28° [95% CI: 13–44; p = 0.003], respectively).ConclusionThese observations show a beneficial effect of flexor tenotomy on biomechanical and musculoskeletal outcomes in the toes, without ulcer recurrence.

Radioulnar interphalangeal joint angles in children and adolescents aged 0 to 19 years.

The purpose of this study is to determine the normal ranges of radioulnar (i.e. medial-lateral) finger deviations during growth. We retrospectively measured radioulnar interphalangeal joint angles in 6236 properly aligned thumbs and fingers in trauma radiographs of 4720 patients aged 0 to 19 years. The mean interphalangeal joint angle of the thumb was 0.2° (standard deviation 1.5°). The average proximal interphalangeal joint angles were ulnar deviation of 2.5° (1.7°) for the index, ulnar deviation 1.7° (1.5°) for the middle, radial deviation 1.3° (1.8°) for the ring, radial deviation 2.0° (2.8°) for the little fingers. The distal interphalangeal joint angles were ulnar deviation of 2.5° (1.7°), ulnar deviation 2.1° (1.7°), radial deviation 2.1° (1.7°), radial deviation 5.1° (2.8°) from index to the little fingers. Thumbs were typically straight, whereas the index and middle fingers deviated ulnarly, and ring and little fingers radially. There were no relevant differences in sex or laterality.

Post-traumatic clinodactyly of the little finger in Basque hand-pelota players

ObjectiveThe aim of this study is to measure the DIP joint angle of the little finger and presence of degenerative changes in the DIP joint in Basque hand-pelota players and compare it with the general Spanish population. Material and methodsCross-sectional study. We studied both hands of 40 male Basque pelota players (pelotaris) and 20 male controls. The assessment protocol consisted of a questionnaire, physical examination and bilateral plain radiographs. Distal interphalangeal (DIP) joint angle was measured on plain radiographs in both hands. ResultsThe average DIP joint angle of the little finger in the control group was 2.6° in the dominant hand and 2.9° in the other hand. In the pelota players group we obtained a DIP angle of 6.8° in the dominant hand and 10.9° in the non-dominant hand. The DIP angle was significantly higher in the non-dominant hand (p=.002) in the pelota player group. Non-significant differences were obtained between both hands in the control group (p=.572). Significant differences were obtained in both player and control groups in the dominant hand (p=.001) and in the non-dominant hand (p=.001). Pelota players have a higher DIP angle in the little fingers than the control group. No differences were found in the pelota player group according to their position on the court (p=.742 forward, p=.747 defender) or sport level (p=.345 amateur, p=.346 professional). DiscussionBasque hand-pelota produces post-traumatic acquired clinodactyly of the little finger. The non-dominant hand has a higher DIP joint angle. Clinodactyly poses no functional problems.

Clinodactilia postraumática del meñique en el pelotari manista

ObjectiveThe aim of this study is to measure the DIP joint angle of the little finger and presence of degenerative changes in the DIP joint in Basque hand-pelota players and compare it with the general Spanish population. Material and methodsCross-sectional study. We studied both hands of 40 male Basque pelota players (pelotaris) and 20 male controls. The assessment protocol consisted of a questionnaire, physical examination and bilateral plain radiographs. Distal interphalangeal (DIP) joint angle was measured on plain radiographs in both hands. ResultsThe average DIP joint angle of the little finger in the control group was 2.6° in the dominant hand and 2.9° in the other hand. In the pelota players group we obtained a DIP angle of 6.8° in the dominant hand and 10.9° in the non-dominant hand. The DIP angle was significantly higher in the non-dominant hand (P=.002) in the pelota player group. Non-significant differences were obtained between both hands in the control group (p=.572). Significant differences were obtained in both player and control groups in the dominant hand (P=.001) and in the non-dominant hand (P=.001). Pelota players have a higher DIP angle in the little fingers than the control group. No differences were found in the pelota player group according to their position on the court (P=.742 forward, P=.747 defender) or sport level (P=.345 amateur, P=.346 professional). DiscussionBasque hand-pelota produces post-traumatic acquired clinodactyly of the little finger. The non-dominant hand has a higher DIP joint angle. Clinodactyly poses no functional problems.

Bio-inspired tendon driven mechanism for simultaneous finger joints flexion using a soft hand exoskeleton.

A new tendon driven mechanism, embedded into a soft hand exoskeleton for rehabilitation and assistance, was proposed in this study. The proposed solution was a pulley flexion mechanism inspired by the human musculoskeletal system to enable a natural and comfortable finger flexion. A biomechanical constraint for the finger flexion motion states that the relation between the proximal interphalangeal joint angle of the finger should always be flexed around 1.5 times the distal interphalangeal joint angle. The study aimed to comply with this constraint, by simultaneously distributing the forces over the distal and middle finger phalanges. For evaluation, the voluntary and exoskeleton flexions were compared based on the relation between the proximal and distal interphalangeal joint angles. The results showed that during the exoskeleton flexion the relation between the interphalangeal joints complied with the biomechanical constraint, where the proximal interphalangeal joint angle was 1.5 times larger than the distal interphalangeal joint. This ensures that the mechanism flexes the finger comfortably. The proposed solution is therefore a promising design for a novel soft exoskeleton that will be used for training and assistance of patients with hand paralysis.

Effect of Smartphone Size on the Hand Muscle Fatigue

This study aimed to investigate the effect of smartphone size and use on fatigue of the extensor pollicis longus and abductor digiti minimi, and digiti minimi deformity. The 40 people assigned to the experimental group spent at least 6 hours using the smartphone and used the digiti minimi for support. The control group spent at least 3 hours using the smartphone, however did not use digiti mini for support. Questionnaires were used to measure smartphone usage, daily use duration, and method of holding the smartphone device. X-rays of distal interphalangeal joint angle deformity of the digiti minimi were assessed. Surface electromyography was used to analyze muscle fatigue. The angle deformity was significantly different between the experimental group and the control group, and fatigue of the extensor pollicis longus and abductor digiti minimi of the large smartphone users were high. The muscle fatigue was reduced when the smartphone size fit well with the user's hand. This study suggests that the size of the smartphone influence the fatigue of the hand muscles.

RADIOGRAPHIC MEASUREMENTS OF HOOF BALANCE ARE SIGNIFICANTLY INFLUENCED BY A HORSE'S STANCE.

Hoof balance radiographs are commonly used as the basis for corrective farriery decision-making in horses, however there are limited published data quantifying effects of the stance of the horse or the horizontal radiographic beam angle. In this analytical study, the influence of variation of the horse's stance in the craniocaudal and lateromodial plane on hoof balance measurements as well as the influence of variation of the horizontal radiographic beam angle on dorsopalmar hoof balance measurements was examined. Distal left thoracic limb lateromedial radiographs were acquired using a standardized protocol while varying the craniocaudal stance of five horses, each selected to be sound and conformationally normal. Dorsopalmar foot radiographs were acquired while varying the lateromedial stance; and variable angle horizontal beam dorsopalmar foot radiographs were acquired while keeping the limb position constant. Analyses of measurements demonstrated that hoof pastern angle had a linear relationship (R2 = 0.89, P < 0.001) with craniocaudal stance of the horse. The relationship of joint angle and stance was greater for the distal interphalangeal joint angle (R2 = 0.89, P < 0.001) than the proximal interphalangeal joint angle (R2 = 0.65, P = 0.001). The distal phalanx angle did not change with craniocaudal stance variation. The proximal interphalangeal joint width, distal interphalangeal joint width, or distal phalanx height did not change with lateromedial stance variation, nor within a 15 degree dorsolateral to caudomedial and dorsomedial to caudolateral variation from the dorsopalmar axis. Findings indicated that positioning of the thoracic limb needs to be considered during radiographic interpretation and decision-making for corrective farriery.

Movement of finger joints induced by synergistic wrist motion

Background. An experiment has recently been conducted to evaluate and compare the differences in tendon excursions between the flexor digitorum profundus and superficialis using three mobilization techniques. No previous studies deal with the total joint excursions with constant tendon length. The purpose of this study was to investigate the coordinated motion between the finger and wrist joints resulting from passive tension of the muscles while performing synergistic wrist motion. Methods. The relative joint positions of the hand and wrist were measured using a three-dimensional motion analysis system with external retroreflective markers 2 mm in diameter placed on the dorsal surface of the hand. Fifty normal subjects, with a 1:1 gender ration, ranging in age from 20 to 40 years, and with no previous history of upper extremity injury, were recruited for the experiment. Findings. The relationships of synergistic motion between the wrist and finger joints due to passive tension in the muscles were approximately linear. The ranges of wrist motion averaged 60° extension and 60° flexion. Moving the wrist from flexion into extension induced synergistic finger joint motion as follows: the distal interphalangeal joint angles changed from an average of 12° of flexion to 31°; proximal–interphalangeal joint angles changed from 19° to 70°; and metacarpal phalangeal joints changed from 27° to 63° of flexion. Interpretation. The relationships of synergistic motion between the wrist and finger joints were systematically documented. Such a relationship could be considered in optimizing the design of dynamic splints used for rehabilitation in post-surgical tendon repair, as well as providing useful information about potential diagnoses of problems with the integrity of the flexor and extensor mechanisms.

Intrinsic muscle atrophy and toe deformity in the diabetic neuropathic foot: a magnetic resonance imaging study.

The objectives of this study were to compare intrinsic foot muscle cross-sectional area (CSA) in patients with diabetic polyneuropathy and nondiabetic control subjects and to examine the association between intrinsic muscle CSA and clawing/hammering of the toes in neuropathic feet. High-resolution T2-weighted fast spin-echo images and parametric T2 multiple spin-echo images were acquired using multiple spin-echo magnetic resonance imaging (MRI) of frontal plane sections of the metatarsal region of the foot in a sample of eight individuals with diabetic polyneuropathy and eight age- and sex-matched nonneuropathic nondiabetic control subjects. The configuration of joints of the second toe was obtained using a three-dimensional contact digitizer. Remarkable atrophy was found in all the intrinsic muscles of neuropathic subjects as compared with nondiabetic control subjects. Quantitative T2 analysis showed a 73% decrease in muscle tissue CSA distally in the neuropathic subjects. Muscle comprised only 8.3 +/- 2.9% (means +/- SD) of total foot CSA compared with 30.8 +/- 3.9% in control subjects. No significant differences were found between the groups in the metatarso-phalangeal and proximal and distal interphalangeal joint angles of the second ray. Moreover, clawing/hammering of the toes was found in only two of eight neuropathic subjects. Although sensory neuropathy is often emphasized in considerations of diabetic foot pathology, our results show that the consequences of motor neuropathy in the feet are profound in people with diabetes. This has implications for foot function and may play a significant role in postural instability. However, intrinsic muscle atrophy does not necessarily appear to imply toe deformity.

Effect of oxytetracycline on metacarpophalangeal and distal interphalangeal joint angles in newborn foals

Summary Thirty-five newborn foals were assigned to 1 of 3 groups and treated with 0.9% NaCl solution (saline; group 1; n = 12), oxytetracycline (44 mg/kg of body weight; group 2; n = 12), or 2-pyrrolidone (oxytetracycline vehicle; group 3; n = 11) in saline solution during the first 36 hours after birth. Serum biochemical analyses were performed on samples obtained from group-1 and group-2 foals before treatment and 24 and 96 hours after treatment. Lateral to medial radiographic views of the forelimbs were obtained before treatment and 24 and 96 hours after treatment in all foals. Metacarpophalangeal and distal interphalangeal joint angles were measured from the radiographic images. Significant changes in blood chemistry values, other than those typically observed in newborn foals, were not detected. A significant decrease in mean metacarpophalangeal joint angle was observed in foals 24 hours after treatment with oxytetracycline, compared with that in foals of groups 1 and 3. The mean metacarpophalangeal joint angle returned to pretreatment values by 96 hours. Oxytetracycline appears to be an effective method for obtaining a short-term moderate decrease in metacarpophalangeal joint angle in newborn foals.