Basics of Musculoskeletal

Biomechanic

Ahmad Fauzi
Divisi Orthopaedi & Traumatologi
Ilmu Bedah FK UNILA

Biomechanic of Trauma
Biomechanic of The Hip
Biomechanic of The Knee
Biomechanic of The Ankle

BIOMECHANIC OF TRAUMA
(Fracture)

BIOMECHANICS
The study of forces acting on & generated within
the body
The study of forces & their effects on living
biologic systems
Interdisciplinary approach (anatomy, physiology,
mechanics, medicine, engineering, psychology)

 Basis of biomechanical principle : Newtons

Laws
1st Law : Body will remain at rest / move with
a constant velocity if the resultant force acting
on it is equal to zero.

Newtons Laws
2nd Law : If the resultant force acting is not equal
to zero the body will have an acceleration that
is directly proportional to the magnitude of the
force & inversely proportional to the mass

3rd Law : For every action reaction equal in

magnitude & opposite in direction

Basic Biomechanics
Force, Displacement & Stiffness

Applied
Force

Slope = Stiffness =
Force/Displacement

Displacement

Loads : Forces that act an a body

(Compression, tension, shear, torsion )

Deformations : Temporary (elastic) or

permanent (Plastic ) change in the shape of the
body. Change in load produce changes in
deformation

Basic Biomechanics
Force

Elastic Deformation
Plastic Deformation
Energy

Elastic

Plastic

Energy
Absorbed

Displacement

 Strength of bone composite structure

collagen providing the tensile strength &
hydroxyapatite providing the compressive
strength

Bone Biomechanics
Normal cortical (bone lamellar bone) highly
organized and relatively hypocellular
Cortical bone 80% of the skeleton,
Composed tightly packed Haversian system,
Characterized : slow bone turnover rate

 Cancellous bone less dense,

Higher turnover rate, and
Undergoes greater remodelling according
to the lines of stress (Wolffs law)

Schematic Diagram of a Long Bone

Bone Biomechanics
Properties of the bone that important in resisting
a fracture :
Energy absorbing capacity,
Youngs modulus of elasticity (E)
represents the material stiffness & ability to
resist deformation when a force is applied
(N=M2) or Pascals (Pa).
Fatigue strength, and
Density

Fracture Biomechanics
Factors for production of fractures
Magnitude,
Duration,
Direction of the forces acting on the bone, and
The rate at which the bone is loaded
Principal stress planes
Bending
Axial loading : tension, compression
Torsion

Fracture Biomechanics
Characteristics of the force causing fractures
single force of significant magnitude, or
repetitive low magnitude forces
Classified by Mechanism of Injury
Direct, and
indirect forces

 Combination of the bones material strength &

excessive anisometric ext load stress properties
FRACTURE & Pattern of fracture

Fracture Biomechanics
Bending
Axial Loading
Tension
Compression
Torsion

Bending

Compression

Torsion

Fracture Biomechanics

Figure from: Browner et al: Skeletal Trauma 2nd Ed, Saunders, 1998.

The Fracture Pattern of Long Bones

Corresponding to the Type of External Load

Fracture Biomechanics
Bending load:
Compression strength >
tensile strength
Fails in tension

Figure from: Tencer. Biomechanics in Orthopaedic

Trauma, Lippincott, 1994.

Fracture Biomechanics
Combined bending & axial load
Oblique fracture
Butterfly fragment

Figure from: Tencer. Biomechanics in Orthopaedic

Trauma, Lippincott, 1994.

Fracture Biomechanics
Torsion
The diagonal in the direction of the applied force
is in tension cracks perpendicular to this
tension diagonal
Spiral fracture 45 to the long axis

Figures from: Tencer. Biomechanics in Orthopaedic

Trauma, Lippincott, 1994.

Resultant Tension Crack by a Torsional Load

Fractures

A single trauma incident

Repetitive stress
Abnormal weakening of the bone

 Most Fractures are caused sudden and

excessive force
Direct force
Indirect force

A direct force
The bone breaks at the point of impact
Soft tissues also must be damaged
a direct blow usually causes a transverse
fracture and damage to the overlying skin
Crushing comminuted fracture with
extensive soft-tissue damage

A direct force

A direct force

A direct force

A direct force

An indirect force

The bone breaks at a distance from where force

is applied
Soft-tissue damage at the fracture site is not
inevitable
Almost fractures are due to a combination of
forces

Bending
Tensile
Compression
Twisting

An indirect force

Spine

Summary
Biomechanics : The study of forces acting on &
generated within the body
Basis of biomechanical principle : Newtons
Laws
Combination of the bones material strength &
excessive anisometric properties cause fracture
Mechanism of injury and loading imply Pattern
of fracture
Most Fractures are caused sudden and
excessive force, either direct or indirect force

Biomechanic of The Hip

 Anatomical considerations
The Acetabulum
The Femoral Head
The Femoral Neck

Kinematics
Range of Motion
Surface joint Motion

Kinetics
Statics
Dynamics
Effect of External Support on Hip Joint Reaction Force

 One of the largest and most stable joint : The hip

joint
Rigid ball-and-socket configuration (Intrinsic
stability)

Anatomy
Composed of :
Head of femur
Acetabulum of pelvis

18 16 7 9

Wide range of motion

Walking, sitting, squatting

Anatomy
Surrounding large, strong muscles

Acetabulum
Concave component of ball
and socket joint
Cover with articular
cartilage
Provide with static stability

The femoral head

Femoral head : convex component
Two-third of a sphere
Cover with cartilage
Rydell (1965) suggested : most load
superior quadrant

The femoral neck

Frontal plane (the neck-to-shaft angle)
Transverse plane (the angle of anteversion)

 Neck-to-shaft angle :
125, vary from 90 to 135
Effect : lever arms

Neck-to-shaft angle & Abductor muscle

force

 Angle of anteversion : 12
Effect : during gait
>12 : internal rotation
<12 : external rotation

Joint reaction force

medial trabecular system

Frankel, 1960

Kinematics
Hip motion takes place in all three planes :
sagittal (flexion-extension)
frontal (abduction-adduction)
transverse (internal-external rotation)
Muscle, ligament and configuration
asymmetric

Kinematics
Range of motion : sagittal, frontal, transverse

0~140

0~15

0~30

0~25

0~90

0~70

Kinematics
Old man : shorter
strides
Decrease:
Rang of hip flexion,
extension
Plantar flexion of ankle
Heel-floor angle

Old man

Young man

Several factors :
a wider female pelvis
a difference in the inclination of the femoral
neck-to-shaft angle
a difference in footwear
and differences in the general pattern of gait

Biomechanic of The Knee

 Tibiofemoral joint
3 plane: sagital, frontal, transversal

Instant center TF joint

Semicircular

Contact point
Tangensial = gliding

Extension flexion distraction compression

Meniscus

Biomechanic of The Ankle

Ankle Joint Biomechanics

Ankle Dorsiflexion
Anterior Talar Dome
Wider
More Stability
More Tibiotalar Contact
Fibula Moves Laterally

Ankle Joint Biomechanics

Tibial Plafond 3o Valgus

Effects of Oblique Ankle Axis

Ankle Dorsiflexion
Foot External Rotation
Tibia Internal Rotation
Ankle Plantarflexion
Foot Internal Rotation
Tibial External Rotation

Arch Support
Beam and Truss
No Muscle Activity with
Relaxed Standing
Plantar Fascia

Normal Gait
Bipedal Mode of Locomotion
Goals
Mobility
Minimal Energy Expenditure
Minimal Stress on
Bones
Joints
Muscles

Normal Gait

Normal Gait

Toe Off

SWING PHASE

Heel Rise

Flatfoot

STANCE PHASE

Heel Strike

 Weight-Bearing Progresses from

Lateral Heel to Great Toe