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39. Neck Braces and Driving Posture Affect Neck Mobility on Powered Two-Wheelers

Author

Lecoublet, Brieg, Petit, Yvan, Wagnac, Eric, Boisclair, Dominic, and Arnoux, Pierre-Jean

Subjects
musculoskeletal diseases, Transportation engineering, motorcyclist, powered two-wheeler, neck brace, cervical spine, neck mobility, driving posture, TA1001-1280, musculoskeletal system
Abstract

Cervical spine injuries are a major concern for motorcyclists in traffic accidents and racing competitions. Neck braces aim to prevent cervical spine injuries during accidents by reducing the neck range of motion, and keeping it under physiological limits. This work aims to evaluate the ability of neck braces to reduce neck mobility for two driving postures associated with PTW configurations. The neck mobility of twelve volunteer subjects testing four neck braces on two powered two-wheelers (scooter and racing motorbike) is measured using an optoelectronic motion capture system. With the tested neck braces worn, neck mobility is significantly reduced as compared to the physiological range of motion in all degrees of freedom. However, only flexion/extension is reduced by all neck braces tested. This suggests that these brace designs do not provide protection against all the cervical spine loading directions that may occur in a trauma. Furthermore, specific type of each powered two-wheeler considered significantly affects the neck mobility in axial rotation, as well as the postero-anterior and caudo-cranial translations, thus underscoring the need to consider the driving posture when evaluating neck brace devices.

Published
2021

43. Instrumentation of the sacroiliac joint with cylindrical threaded implants: A detailed finite element study of patient characteristics affecting fixation performance

Author

Shang, Shi, Masson, Catherine, Llari, Maxime, Py, Max, Ferrand, Quentin, Arnoux, Pierre-Jean, Simms, Ciaran, Laboratoire de Biomécanique Appliquée (LBA UMR T24), and Aix Marseille Université (AMU)-Université Gustave Eiffel

Subjects
Materials science, Arthrodesis, medicine.medical_treatment, 0206 medical engineering, Finite Element Analysis, Joint stability, 02 engineering and technology, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Orthopedics and Sports Medicine, Range of Motion, Articular, [PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph], Reduction (orthopedic surgery), ComputingMilieux_MISCELLANEOUS, Fixation (histology), 030203 arthritis & rheumatology, Orthodontics, Sacroiliac joint, Biomechanics, Sacroiliac Joint, Prostheses and Implants, 020601 biomedical engineering, Biomechanical Phenomena, medicine.anatomical_structure, Spinal Fusion, Implant, Range of motion
Abstract

The sacroiliac joint (SIJ) is a known pain generator that, in severe cases, may require surgical fixation to reduce intra-articular displacements and allow for arthrodesis. The objective of this computational study was to analyze how the number of implants affected SIJ stabilization with patient-specific characteristics such as the pelvic geometry and bone quality. Detailed finite element models were developed to account for three pelvises of differing anatomy. Each model was tested with a normal and low bone density (LD) under two types of loading: compression only and compression with flexion and extension moments. These models were instrumented with one to three cylindrical, threaded and fenestrated implants through a posterior oblique trajectory, requiring less muscle dissection than the more common lateral trajectory used with triangular implants. Compared with the noninstrumented pelvis, the change in range of motion (ROM) and stress distribution were used to characterize joint stabilization. Noninstrumented mobility ranged from 0.86 to 2.55 mm and from 1.37° to 6.11°. Across patient-specific characteristics, the ROM reduction with one implant varied from 3% to 21% for vertical and 15% to 47% for angular displacements. With two implants, the ROM reduction ranged from 12% to 41% for vertical and from 28% to 61% for angular displacements. Three implants, however, did not further improve the joint stability (14% to 42% for vertical and 32% to 63% for angular displacements). With respect to patient characteristics, an LD led to a decreased stabilization and a higher volume of stressed bone (>75% of yield stress). A better understanding of how patient characteristics affect the implant performance could help improve surgical planning of sacroiliac arthrodesis.

Published
2021
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45. Biomechanical evaluation of Back injuries during typical snowboarding backward falls.

Author

Wei, Wei, Evin, Morgane, Bailly, Nicolas, and Arnoux, Pierre‐Jean

Subjects
BACK injuries, FINITE element method, SAFETY, SNOWBOARDING injuries, ACCIDENTAL falls, BIOMECHANICS
Abstract

To prevent spinal and back injuries in snowboarding, back protector devices (BPDs) have been increasingly used. The biomechanical knowledge for the BPD design and evaluation remains to be explored in snowboarding accident conditions. This study aims to evaluate back‐to‐snow impact conditions and the associated back injury mechanisms in typical snowboarding backward falls. A previously validated snowboarder multi‐body model was first used to evaluate the impact zones on the back and the corresponding impact velocities in a total of 324 snowboarding backward falls. The biomechanical responses during back‐to‐snow impacts were then evaluated by applying the back‐to‐snow impact velocity to a full human body finite element model to fall on the snow ground of three levels of stiffness (soft, hard, and icy snow). The mean values of back‐to‐snow normal and tangential impact velocities were 2.4 m/s and 7.3 m/s with maximum values up to 4.8 m/s and 18.5 m/s. The lower spine had the highest normal impact velocity during snowboarding backward falls. The thoracic spine was found more likely to exceed the limits of flexion‐extension range of motions than the lumbar spine during back‐to‐snow impacts, indicating a higher injury risk. On the hard and icy snow, rib cage and vertebral fractures were predicted at the costal cartilage and the posterior elements of the vertebrae. Despite the possible back injuries, the back‐to‐snow impact force was always lower than the force thresholds of the current BPD testing standard. The current work provides additional biomechanical knowledge for the future design of back protections for snowboarders. [ABSTRACT FROM AUTHOR]

Published
2023
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46. Spinal Fractures during Touristic Motorboat Sea Cruises: An Underestimated and Avoidable Phenomenon.

Author

May, Adrien Thomas, Bailly, Nicolas, Sellier, Aurore, Avinens, Valentin, Huneidi, Maxime, Meyer, Mikael, Troude, Lucas, Roche, Pierre-Hugues, Dufour, Henry, Dagain, Arnaud, Arnoux, Pierre-Jean, Farah, Kaissar, and Fuentes, Stéphane

Subjects
VERTEBRAL fractures, OCEAN travel, MOTORBOATS, COMPRESSION fractures, SPINAL injuries, BONE fractures
Abstract

Purpose: Each summer, many vacationers enjoy the Mediterranean Sea shores. Among the recreational nautical activities, motorboat cruise is a popular choice that leads to a significant number of thoracolumbar spine fractures at our clinic. This phenomenon seems to be underreported, and its injury mechanism remains unclear. Here, we aim to describe the fracture pattern and propose a possible mechanism of injury. Methods: We retrospectively reviewed the clinical, radiological, and contextual parameters of all motorboat-related spinal fracture cases during a 14-year period (2006–2020) in three French neurosurgical level I centers bordering the Mediterranean Sea. Fractures were classified according to the AOSpine thoracolumbar classification system. Results: A total of 79 patients presented 90 fractures altogether. Women presented more commonly than men (61/18). Most of the lesions occurred at the thoracolumbar transition region between T10 and L2 (88.9% of the levels fractured). Compression A type fractures were seen in all cases (100%). Only one case of posterior spinal element injury was observed. The occurrence of neurological deficit was rare (7.6%). The most commonly encountered context was a patient sitting at the boat's bow, without anticipating the trauma, when the ship's bow suddenly elevated while crossing another wave, resulting in a "deck-slap" mechanism hitting and propelling the patient in the air. Conclusions: Thoracolumbar compression fractures are a frequent finding in nautical tourism. Passengers seated at the boat's bow are the typical victims. Some specific biomechanical patterns are involved with the boat's deck suddenly elevating across the waves. More data with biomechanical studies are necessary to understand the phenomenon. Prevention and safety recommendations should be given before motorboat use to fight against these avoidable fractures. [ABSTRACT FROM AUTHOR]

Published
2023
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