Three-dimensional kinematics of the proximal interphalangeal joint: effects of raising the heels or the toe.

The proximal interphalangeal joint (PIPJ) has always been considered as a low-motion joint with an almost constant angle during loading of the limb. Until very recently, its motion was not taken into account in kinematic studies in vivo. Recent in vivo studies yielded surprisingly high ranges of motion in this joint. The aim of this study was to measure, in terms of the 3 possible rotations (flexion/extension, collateromotion and axial rotation), the movements of the PIPJ in vitro during limb loading in a neutral position (500-6000 N) and after the addition of heel and toe wedges (6 degrees and 12 degrees). The joint coordinate system, as it was recently described for use in the horse, was used to compute the 3 components of rotation. With the hoof in neutral position, low-amplitude flexion movements (7.9 degrees) were observed. They were not associated with collateromotion or axial rotation. The flexion of the joint increased exponentially with load suggesting that, during the midstance phase, heavy loads are necessary to evoke substantial flexion. Raising the heels induced an early flexion of the joint with an increase of its total amplitude. Raising the toe produced an extension at 500 N, beyond which the amount of flexion was reduced. These results show that PIPJ flexion/extension during in vitro loading remains substantially smaller than suggested by in vivo studies based on skin markers. Raising the toe or heel directly affects the behaviour of this joint, but does not induce motion outside the sagittal plane. Hoof wedges are commonly used in clinical practice for purposes other than affecting PIPJ motion. In these cases, their biomechanical effects on this joint should be taken into account.

Normal three-dimensional behaviour of the metacarpophalangeal joint and the effect of uneven foot bearing.

The purpose of this study was to quantify small amplitude rotational movements in the metacarpophalangeal joint (MPJ) of the horse and to measure the influence of asymmetric placement of the foot on these articular angles. Trihedrons, supporting kinematic markers defining a local frame, were screwed into the third metacarpal bone and the proximal phalanx of 4 isolated forelimbs. The limbs were loaded in a press, and the lateral or medial aspects of the foot were raised alternately by a 12 degrees wedge. The use of the joint coordinate system permitted the simultaneous and continuous computing of the 3 angles of rotation of the joint. During neutral loading, the extension of the MPJ (38.4 +/- 8.7 degrees) was associated with lateral axial rotation of the proximal phalanx (1.8 +/- 0.9 degrees). Addition of a lateral wedge induced medial rotation (-0.9 +/- 0.2 degree) and abduction (2.1 +/- 0.4 degrees) of the proximal phalanx. The opposite phenomenon was observed with a medial wedge. These quantitative results confirmed the combination of axial rotation and widening of the articular space on the opposite side to the raised part of the foot that had earlier been observed in semi-quantitative studies. Despite the high congruence of this joint, this study demonstrated the significant influence of uneven bearing of the foot on the three-dimensional (3-D) behaviour of the MPJ. Even though the amplitude of these movements remained small, their biomechanical effects should be considered to improve our understanding of MPJ injuries and to rationalise exercise management and corrective shoeing in the lame horse.

Concrete use of the joint coordinate system for the quantification of articular rotations in the digital joints of the horse.

A method is detailed allowing the computation of three-dimensional (3D) joint angles. Each joint of the equine digit is modelled as a sequence of three single axis rotary joints. The Joint Coordinate System was used; it involves a specific sequence of cardanic angles. The decomposition of the angles was chosen so that the three elementary angles coincide with the flexion/extension, passive abduction/adduction and lateral/medial rotations. The algorithms and kinematic procedures were described for the equine front digital joints. This method was tested in vitro on four forelimbs. For each limb, angle values were measured while the member was loaded by a press (from 500 to 6000 N). These tests were repeated while a wedge raised one part of the hoof (toe, heel, lateral and medial sides) in order to induce modifications of the angular patterns of the joints. This method allowed a precise quantitative determination of 3D joint movements. The modifications occurring with the wedges are clearly identified and confirm some previously published semi-quantitative observations. Moreover, this method provides a way to collect objective data on the functional anatomy of joints and could be used to study connective shoeing thoroughly. It may be directly applied to other species and may be used by researchers interested in discreet articular movements, especially occurring in other planes than the sagittal one.