Anatomical descriptions of the hand have failed to explain the vulnerabilities and unsatisfactory outcomes to even slight damage to its network of tendinous interconnections. We propose that these classical anatomical descriptions do not capture the severe functional interdependence among its multiple elements. We will use an alternative structural inference approach base on bioinformatic testing of cadaver specimens to find the sensitivities and vulnerabilities of the tendinous apparatus. Hypothesis I: Classical anatomical descriptions of the tendinous apparatus do not capture the interdependencies among tendons and therefore fail to explain the vulnerability of finger function to injury. Hypothesis II: Anatomical descriptions inferred directly from finger force and motion data are better than classical descriptions at capturing the interdependencies among tendons and explain how injury results in deformity and pathologic finger motion.
Aim 1 : Quantify the fidelity of classical anatomical descriptions by comparing predicted vs. measured static fingertip forces and unloaded finger motions in a variety of postures.
Aim 2 : Mathematically infer alternative anatomical descriptions from cadaver data, and quantify their fidelity by comparing predicted vs. measured static fingertip forces and unloaded finger motions in a variety of postures.
Aim 3 : Validate the clinical usefulness of the best resulting anatomical descriptions by performing selective injuries in cadaver hands, and comparing predicted vs. measured deformity and pathologic finger motion. This work is made possible by our novel and validated data-driven bioinformatics approach to infer the functional structure of complex physical systems by autonomously interrogating them. We will infer anatomical descriptions of the fingers and tendinous apparatus by measuring fingertip forces and motion in response to a minimal number of automatically generated tendon tensions and excursions, respectively, delivered by a computer-controlled cadaver actuation system. Future Aims: Establishing the structure, function and vulnerabilities of the tendinous apparatus will have great clinical impact. This work will lead to understanding why and how injuries to the tendinous apparatus, or muscle imbalances, often result in deformity, pathologic finger motion and force deficits
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