An investigation of tendon strains in jersey finger injury load cases using a finite element neuromuscular human body model

Lennart V Nölle; Eduardo Herrera Alfaro; Oleksandr V Martynenko; Syn Schmitt

doi:10.3389/fbioe.2023.1293705

An investigation of tendon strains in jersey finger injury load cases using a finite element neuromuscular human body model

Front Bioeng Biotechnol. 2023 Dec 14:11:1293705. doi: 10.3389/fbioe.2023.1293705. eCollection 2023.

Authors

Lennart V Nölle¹, Eduardo Herrera Alfaro¹, Oleksandr V Martynenko¹, Syn Schmitt^{1

2}

Affiliations

¹ Institute for Modelling and Simulation of Biomechanical Systems, University of Stuttgart, Stuttgart, Germany.
² Stuttgart Center for Simulation Science, University of Stuttgart, Stuttgart, Germany.

Abstract

Introduction: A common hand injury in American football, rugby and basketball is the so-called jersey finger injury (JFI), in which an eccentric overextension of the distal interphalangeal joint leads to an avulsion of the connected musculus flexor digitorum profundus (FDP) tendon. In the field of automotive safety assessment, finite element (FE) neuromuscular human body models (NHBMs) have been validated and are employed to evaluate different injury types related to car crash scenarios. The goal of this study is to show, how such a model can be modified to assess JFIs by adapting the hand of an FE-NHBM for the computational analysis of tendon strains during a generalized JFI load case. Methods: A jersey finger injury criterion (JFIC) covering the injury mechanisms of tendon straining and avulsion was defined based on biomechanical experiments found in the literature. The hand of the Total Human Model for Safety (THUMS) version 3.0 was combined with the musculature of THUMS version 5.03 to create a model with appropriate finger mobility. Muscle routing paths of FDP and musculus flexor digitorum superficialis (FDS) as well as tendon material parameters were optimized using literature data. A simplified JFI load case was simulated as the gripping of a cylindrical rod with finger flexor activation levels between 0% and 100%, which was then retracted with the velocity of a sprinting college football player to forcefully open the closed hand. Results: The optimization of the muscle routing node positions and tendon material parameters yielded good results with minimum normalized mean absolute error values of 0.79% and 7.16% respectively. Tendon avulsion injuries were detected in the middle and little finger for muscle activation levels of 80% and above, while no tendon or muscle strain injuries of any kind occurred. Discussion: The presented work outlines the steps necessary to adapt the hand model of a FE-NHBM for the assessment of JFIs using a newly defined injury criterion called the JFIC. The injury assessment results are in good agreement with documented JFI symptoms. At the same time, the need to rethink commonly asserted paradigms concerning the choice of muscle material parameters is highlighted.

Keywords: finite element analysis; injury criteria; jersey finger injury; muscle modelling; tendon strain injury.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) under Germany’s Excellence Strategy—EXC 2075—390740016 (SimTech) and by the Federal Ministry for Economic Affairs and Climate Action of Germany (Bundesministerium für Wirtschaft und Klimaschutz) through the project “Artificial Intelligence for Real-Time Injury Prediction (ATTENTION),” grant number 19A21027D.