{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:32:24Z","timestamp":1777926744937,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2012,7,16]],"date-time":"2012-07-16T00:00:00Z","timestamp":1342396800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Proc Inst Mech Eng H"],"published-print":{"date-parts":[[2012,10]]},"abstract":"<jats:p>Stiffness and contracture of the periarticular tissues are common complications of a post-traumatic elbow. Arthrodiatasis is a surgical technique that uses an external fixator for initial immobilization and subsequent distraction. The two prerequisites for an ideal arthrodiatasis are concentric distraction (avoiding bony contact) and hinge alignment (reducing internal stress). This study used the finite element (FE) method to clarify the relationship between these two prerequisites and the initial conditions (pin placement, elbow angle, and distraction mode). A total of 12 variations of the initial conditions were symmetrically arranged to evaluate their biomechanical influence on concentric distraction and hinge alignment. The humeroulnar surface was hypothesized to be ideally distracted orthogonal to the line joining the tips of the olecranon and the coronoid. The eccentric separation of the humeroulnar surfaces is a response to the non-orthogonality of the distracting force and joining line. Pin placement significantly affects the effective moment arm of the fixing pins to distract the bridged elbow. Both elbow angle and distraction mode directly alter the direction of the distracting force at the elbow center. In general, the hinges misalignment occurs in a direction opposite to the distraction-activated site. After joint distraction, the elastic deflection of the fixing pins inevitably makes both elbow and fixator hinges to misalign. This indicates that both joint distraction and hinge alignment are the interactive mechanisms. The humeroulnar separation is more concentric in the situation of the 120\u00b0 humeral distraction by using stiffer pins with convergent placement. Even so, the eccentric displacement of the elbow hinge is a crucial consideration in the initial placement of the guiding pin to compensate for hinge misalignment.<\/jats:p>","DOI":"10.1177\/0954411912450958","type":"journal-article","created":{"date-parts":[[2012,7,17]],"date-time":"2012-07-17T10:58:49Z","timestamp":1342522729000},"page":"776-786","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Biomechanical influence of pin placement and elbow angle on joint distraction and hinge alignment for an arthrodiatasis elbow\u2013pin\u2013fixator construct"],"prefix":"10.1177","volume":"226","author":[{"given":"Wei-Shiun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering, National Taiwan University of Science and Technology, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shang-Chih","family":"Lin","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taiwan"},{"name":"Biomedical Engineering Research Center, National Taiwan University of Science and Technique, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kao-Shang","family":"Shih","sequence":"additional","affiliation":[{"name":"Division of Orthopedic Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taiwan"},{"name":"School of Medicine, Taipei Medical University, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ching-Kong","family":"Chao","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, National Taiwan University of Science and Technology, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeung-Jen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang-Yuan","family":"Fan","sequence":"additional","affiliation":[{"name":"Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,7,16]]},"reference":[{"key":"bibr1-0954411912450958","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199803000-00033"},{"key":"bibr2-0954411912450958","first-page":"1293","volume":"87","author":"Ring D","year":"2005","journal-title":"J Bone Joint Surg Am"},{"key":"bibr3-0954411912450958","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197557050-00001"},{"key":"bibr4-0954411912450958","first-page":"353","volume":"64","author":"Judet R","year":"1978","journal-title":"Revue de chirurgie orthop\u00e9dique et r\u00e9paratrice de l\u2019appareil moteur"},{"key":"bibr5-0954411912450958","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1097\/00003086-199308000-00007","volume":"293","author":"Morrey BF","year":"1993","journal-title":"Clin Orthop Relat Res"},{"key":"bibr6-0954411912450958","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.89B2.18448"},{"key":"bibr7-0954411912450958","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198062080-00002"},{"key":"bibr8-0954411912450958","doi-asserted-by":"publisher","DOI":"10.1097\/01.bpo.0000150811.33920.27"},{"key":"bibr9-0954411912450958","doi-asserted-by":"publisher","DOI":"10.1097\/01.bpo.0000188995.29050.b9"},{"key":"bibr10-0954411912450958","doi-asserted-by":"publisher","DOI":"10.1054\/jhsb.2000.0425"},{"key":"bibr11-0954411912450958","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2007.0942"},{"key":"bibr12-0954411912450958","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2007.02.014"},{"key":"bibr13-0954411912450958","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2009.07.030"},{"key":"bibr14-0954411912450958","doi-asserted-by":"publisher","DOI":"10.1017\/S1727719100003774"},{"key":"bibr15-0954411912450958","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200001000-00009"},{"key":"bibr16-0954411912450958","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200209000-00017"},{"key":"bibr17-0954411912450958","first-page":"1293","volume":"87","author":"Ring D","year":"2005","journal-title":"J Bone Joint Surg Am"},{"key":"bibr18-0954411912450958","first-page":"84","volume":"201","author":"Regan WD","year":"1985","journal-title":"Clin Orthop Relat Res"},{"key":"bibr19-0954411912450958","first-page":"13","volume-title":"The elbow and its disorders","author":"Morrey BF","year":"2000","edition":"3"},{"key":"bibr20-0954411912450958","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2004.09.032"},{"key":"bibr21-0954411912450958","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200703001-00003"},{"key":"bibr22-0954411912450958","unstructured":"Marsh JL. 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