{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:54:44Z","timestamp":1790812484344,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2005,2,18]],"date-time":"2005-02-18T00:00:00Z","timestamp":1108684800000},"content-version":"vor","delay-in-days":2485,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[1998,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Falls on the outstretched hand are among the most common causes of traumatic bone fracture. However, little is known regarding the biomechanical factors that affect the risk for injury during these events. In the present study, we explored how upper\u2010extremity impact forces during forward falls are affected by modification of surface stiffness, an intervention applicable to high\u2010risk environments such as nursing homes, playgrounds, and gymnasiums. Results from both experimental and linear biomechanical models suggest that during a fall onto an infinitely stiff surface, hand contact force is governed by a high\u2010frequency transient (having an associated peak force F<jats:sub><jats:italic>max1<\/jats:italic><\/jats:sub>), followed by a low\u2010frequency oscillation (having an associated lower magnitude peak force F<jats:sub><jats:italic>max2<\/jats:italic><\/jats:sub>). Practical decreases in surface stiffness attenuate F<jats:sub><jats:italic>max1<\/jats:italic><\/jats:sub> but not F<jats:sub><jats:italic>max2<\/jats:italic><\/jats:sub> or the magnitude of force transmitted to the shoulder. Model simulations reveal that this arises from the compliant surface's ability to decrease the velocity across the wrist damping elements at the moment of impact (which governs F<jats:sub><jats:italic>max1<\/jats:italic><\/jats:sub>) but inability to substantially reduce the peak deflection of the shoulder spring (which governs F<jats:sub><jats:italic>max2<\/jats:italic><\/jats:sub>). Comparison between model predictions and previous data on fracture force suggests that feasible compliant surface designs may prevent wrist injuries during falls from standing height or lower, because F<jats:sub><jats:italic>max1<\/jats:italic><\/jats:sub> will be attenuated and F<jats:sub><jats:italic>max2<\/jats:italic><\/jats:sub> will remain below injurious levels. However, such surfaces cannot prevent F<jats:sub><jats:italic>max2<\/jats:italic><\/jats:sub> from exceeding injurious levels during falls from greater heights and therefore likely provide little protection against upper\u2010extremity injuries in these cases.<\/jats:p>","DOI":"10.1002\/jor.1100160306","type":"journal-article","created":{"date-parts":[[2005,2,24]],"date-time":"2005-02-24T11:16:43Z","timestamp":1109243803000},"page":"309-313","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Surface stiffness affects impact force during a fall on the outstretched hand"],"prefix":"10.1002","volume":"16","author":[{"given":"Stephen N.","family":"Robinovitch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Chiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2005,2,18]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/146642409111100405"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/ip.2.2.98"},{"key":"e_1_2_1_4_2","first-page":"269","article-title":"Transient impact response of the body during a fall on the outstretched hand","volume":"22","author":"Chiu J","year":"1996","journal-title":"Adv Bioeng ASME"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.3109\/ort.1967.38.suppl-108.01"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/8756-3282(95)00383-5"},{"key":"e_1_2_1_7_2","unstructured":"HsiaoET RobinovitchSN:Common protective movements govern unexpected falls from standing height. Unpublished data"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-6870(90)90132-H"},{"key":"e_1_2_1_9_2","first-page":"111","volume-title":"Osteoporosis: Etiology, Diagnosis and Management","author":"Melton LJ","year":"1988"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00298718"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1993.tb07307.x"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02442751"},{"key":"e_1_2_1_13_2","doi-asserted-by":"crossref","first-page":"322","DOI":"10.2106\/00004623-197355020-00007","article-title":"Mechanical properties of bone as a function of rate of deformation","volume":"55","author":"Punjabi MM","year":"1973","journal-title":"J Bone Joint Surg [Am]"},{"key":"e_1_2_1_14_2","volume-title":"Impact Attenuation Performance of Playground Surfacing Material","author":"Ramsey LF","year":"1990"},{"key":"e_1_2_1_15_2","volume-title":"Fractures in Children","author":"Rockwood CA","year":"1984"},{"key":"e_1_2_1_16_2","volume-title":"Injuries Associated with Playground Equipment","author":"Rutherford GW","year":"1978"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.83.5.733"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100120210"},{"key":"e_1_2_1_19_2","first-page":"184","volume-title":"3rd CDC Conference on Injury Control","author":"Streit DA","year":"1993"},{"key":"e_1_2_1_20_2","volume-title":"Division of Hazard Analysis (EPHA)","author":"Tinsworth DK","year":"1989"},{"key":"e_1_2_1_21_2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1542\/peds.69.1.18","article-title":"Playground injuries and voluntary product standards for home and public playgrounds","volume":"69","author":"Werner P","year":"1982","journal-title":"Pediatrics"}],"container-title":["Journal of Orthopaedic Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjor.1100160306","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jor.1100160306","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T15:03:47Z","timestamp":1698505427000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jor.1100160306"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,5]]},"references-count":20,"journal-issue":{"issue":"3","published-print":{"date-parts":[[1998,5]]}},"alternative-id":["10.1002\/jor.1100160306"],"URL":"https:\/\/doi.org\/10.1002\/jor.1100160306","archive":["Portico"],"relation":{},"ISSN":["0736-0266","1554-527X"],"issn-type":[{"value":"0736-0266","type":"print"},{"value":"1554-527X","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,5]]},"assertion":[{"value":"1997-09-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1998-03-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2005-02-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}