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research-article

Pronation-supination motion is altered in a rat model of post-traumatic elbow contracture

[+] Author and Article Information
Chelsey L. Dunham

Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO
chelsey.dunham@wustl.edu

Ryan M. Castile

Department of Mechanical Engineering & Materials Science, Washington University in St. Louis, St. Louis, MO
castiler@wustl.edu

Aaron M. Chamberlain

Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO
amchamberlain@wustl.edu

Leesa M. Galatz

Department of Orthopaedic Surgery, Mount Sinai Hospital, New York, NY
leesa.galatz@mountsinai.org

Spencer P. Lake

ASME Membership Department of Mechanical Engineering & Materials Science, Department of Orthopaedic Surgery, and Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO 1 Brookings Drive, Campus Box 1185 St. Louis, MO 63130
lake.s@wustl.edu

1Corresponding author.

ASME doi:10.1115/1.4036472 History: Received November 30, 2016; Revised April 07, 2017

Abstract

The elbow joint is highly susceptible to joint contracture, and treating elbow contracture is a challenging clinical problem. Previously, we established an animal model to study elbow contracture that exhibited features similar to the human condition including persistent decreased range of motion (ROM) in flexion-extension and increased capsule thickness/adhesions. The objective of this study was to mechanically quantify pronation-supination in different injury models to determine if significant differences compared to control or contralateral persist long-term in our animal elbow contracture model. After surgically inducing soft tissue damage in the elbow, Injury I (anterior capsulotomy) and Injury II (anterior capsulotomy with lateral collateral ligament transection), limbs were immobilized for six weeks (IM). Animals were evaluated after the IM period or following an additional six-weeks of free mobilization (FM). Total ROM for pronation-supination was significantly decreased compared to the uninjured contralateral limb for both IM and FM, although not different from control limbs. Specifically, for both IM and FM, total ROM for Injury I and Injury II were significantly decreased by ~20% compared to contralateral. Correlations of measurements from flexion-extension and pronation-supination divulged that FM did not affect these motions in the same way, demonstrating that joint motions need to be studied/treated separately. Overall, injured limbs exhibited persistent motion loss in pronation-supination when comparing side-to-side differences, similar to human post-traumatic joint contracture. Future work will use this animal model to study how elbow periarticular soft tissues contribute to contracture.

Copyright (c) 2017 by ASME
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