First, the number of specimens was too small even though significant differences were detected with regard to some parameters. Second, the specimens were dissected, preserving only the capsule of the MCP joint. Therefore, the magnitude of parameters assessed in the present study might differ from those of an MCP joint with all soft tissues preserved. Third, only a distraction load was applied in the present study while the major motions of the MCP joint were flexion, extension, abduction, and adduction. Further studies are necessary to investigate the response of the IAP to MCP movements other than axial distraction. Fourth, the displacement measured from the radiographic images was taken with a the sampling rate that was too low, which might have contributed to the differences in stiffness in the neutral zone and toe region when compared with MTS measurements because
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differences in the loading rate and creeping as well as stress relaxation of soft tissue might have contributed to the differences in stiffness parameters from data obtained by the loading device and that of the MTS. Fifth, a manual displacement loading device, with intermittent increases in displacement; was used to calculate the joint volume changes in fixed increments of displacement. The volume obtained might have been different if a continuous distraction mode was applied from the MTS.
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CHAPTER 5 Conclusions
The IAP is a passive stabilizer of the MCP joint. A Micro CT compatible custom-made loading device was developed to obtain displacement, loading, stiffness and joint volume changes in the MCP joint under distraction loads.
In the MTS procedure, the contribution of the IAP to the stability of a MCP joint is mostly in the initial phase, especially during the 1 to 2 kg of total distraction of a 16-kg load. The total volume and IAP in each specimen was highly linear, as well as the necking volume and IAP were also highly correlated negatively. This might lend merit to the concept of the “limited joint volume effect” as a logical rationale for the joint stabilizing effect of IAP.
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