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Functional Kinematics Evaluation of Clavicle Fracture
Figure 1. Clavicle Fracture
This research was the one-year project cooperated with Dr. Li-Wei Hung who is the attending doctor in National Taiwan University Hospital and Department of Orthopedic. The purpose of this study aims to investigate the effects of recovery from clavicle fracture on functional kinematics evaluation after conservative and surgical treatments. My contribution to the research project included scapula locator development, experimental protocol, and data analysis.
Clavicle fractures(Fig. 1), especially the fractures of shoulder girdle are common in adults. Fracture of the shoulder girdle accounts for 35 % to 44 % of clavicle injuries. According to the Allman classification, most of those are middle-third clavicle fractures, which is one of the most frequent fractures in the clinical reports, especially in the athletes who participate in football, cycling, soccer, extreme sports and high-risk activities that involve with hitting, dashing, and falling. Therefore, recovery from clavicle fracture after treatment is most important for athletes to restore the original range of motion of shoulder joint in order to maintain the athletic performance. In clinical practices, conservative treatments, such as the application of a figure of eight bandages, are the most frequent treatments. However, the malunion were reported which lead a poor clinical outcome after the conservative treatment. Recently, surgical treatment has been used to treat the clavicle fracture in order to provide essential support and maintenance with metal fixations attached to the fractured clavicle. Previous studies indicated that the effects of surgical treatment had more advantages than those of the conservative treatment. Thus, the purpose of this study aims to investigate the range of motion of shortening shoulders using 3D motion analysis.
Material and Method
Patients who underwent conservative treatment and surgical treatment were compared to a normal control group. Fifteen subjects were in each group. Clinical tables are applied to evaluate the subjective treatment effects. On the other hand, three-dimensional motion analysis is used to quantify the kinematic parameters during different functional movements of the shoulder complex.
Since we need to locate the scapular complex in many different positions and the skin-move effect of it made us create the scapula locator(Fig. 2). Helping us easier record the position during several conditions.
Figure 2. Scapula Locator
There are two parts of parameters used to assess the recovery effects of two treatments and compared with control group – geometric parameters and kinematic parameters. Each subject's clavicle will divide into three parts, sternal end, shaft, and acromial end, respectively. Total length and included the angle between two parts will be measured from the geometrical model and represent shortening and deformity, so-called geometric parameters. According to the local coordinate system definition and rotation sequence, rotation angles between two segments would be computed. Three groups range of rotation during functional activities would be compared. The joint angles range of motion also called kinematic parameters within the study.
Result and Discussion
Scapular Rhythm reduction is most clearly seen in shoulder abduction
Glenohumeral movement alone is not enough to achieve full range of motion
Scapula should upwardly to assist the movement of the humerus.
Humerus needs to rotate to avoid butting against acromion process
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