Verletzungen der oberen Extremitäten

  • Kai-Uwe SchmittEmail author
  • Peter F. Niederer
  • Duane S. Cronin
  • Markus H. Muser
  • Felix Walz
Part of the VDI-Buch book series (VDI-BUCH)


Im Gegensatz zum Automobil-Bereich sind Verletzungen der oberen Extremitäten im Sport häufig. Sie sind daher entsprechend oft Gegenstand der Forschung. Zahlreiche Studien analysierten die Kinematik der oberen Extremitäten bei unterschiedlichen Bewegungsabläufen wie dem Werfen, einem Golf- oder einem Tennisschlag. Zudem finden sich viele Studien zu Diagnose und Behandlung von Sportverletzungen der oberen Extremitäten. Hinsichtlich Verletzungsmechanismen bestehen jedoch weiterhin viele ungelöste Fragen und bezüglich Verletzungskriterien und Verletzungsgrenzwerten finden sich kaum konklusiven Arbeiten. Um jedoch zuverlässige Präventionsmassnahmen entwickeln zu können, ist die Kenntnis der zugrundeliegenden Verletzungsmechanismen erforderlich.


  1. 1.
    Anderson M, Alford B (2010) Overhead throwing injuries of the shoulder and elbow. Radiol Clin N Am 48:1137–1154CrossRefGoogle Scholar
  2. 2.
    Atkinson P, Hariharan P, Mari-Gowda S, Telehowski P, Martin S, van Hoof J, Bir C, Atkinson C (2002) An under-hand steering wheel grasp produces significant injury risk to the upper extremity during airbag deployment. In: 46th Annual In: Proc. AAAM, S. 45–62Google Scholar
  3. 3.
    Bancroft L (2013) Wrist injuries – a comparison between high- and low-impact-sports. Radiol Clin N Am 51:299–311CrossRefGoogle Scholar
  4. 4.
    Bartlett R (1999) Sports biomechanics. E & FN Spon Publ., LondonCrossRefGoogle Scholar
  5. 5.
    Bass C, Duma S, Crandall J, Morris R, Martin P, Pilkey W, Hurwitz S, Khaewpong N, Eppinger R, Sun E (1997) The interaction of air bags with upper extremities, SAE 973324. In: Proc. 41st Stapp Car Crash Conf., S. 111–129Google Scholar
  6. 6.
    Begeman P, Pratima K, Prasad P (1999) Bending strength of the human cadaveric forearm due to lateral loads. In: Proc. 43rd Stapp Car Crash Conf., SAE 99SC24Google Scholar
  7. 7.
    Bolte J, Hines M, Herriott R, McFadden J, Donnelly B (2003) Shoulder impact response and injury due to lateral and oblique loading. Stapp Car Crash J 47:35–53Google Scholar
  8. 8.
    Brinckmann P, Frobin W, Leivseth G (2002) Musculoskeletal biomechanics. Thieme Publ., StuttgartGoogle Scholar
  9. 9.
    Chiu J, Robinovitch S (1998) Prediction of upper extremity impact forces during falls on the outstrechted hand. J Biomech 31:1169–1176CrossRefGoogle Scholar
  10. 10.
    Chou P, Chou Y, Lin C, Su F, Lous S, Lind C, Huang G (2001) Effect of elbow flexion on upper extremity impact forces during a fall. Clin Biomech 16(10):888–894CrossRefGoogle Scholar
  11. 11.
    Compigne S, Caire Y, Quesnel T, Verriest J (2004) Non-injurious and injurious impact response of the human shoulder three-dimensional analysis of kinematics and determination of injury threshold. Stapp Car Crash J 48:89–123Google Scholar
  12. 12.
    Conroy C, Schwartz A, Hoyt D, Eastman A, Pacyna S, Holbrook T, Vaughan T, Sise M, Kennedy F, Velky T, Erwin S (2007) Upper extremity fracture patterns following motor vehicle crashes differ for drivers and passengers. Injury 38:350–257CrossRefGoogle Scholar
  13. 13.
    Davidsson J (2013) Volunteer shoulder range of motion and stiffness: data for evaluation of crash test dummies and human body models. In: Proc. IRCOBI Conf., paper no. IRC-13-30, S 230–244Google Scholar
  14. 14.
    DeGoede K, Ashton-Miller J (2002) Fall arrest strategy affects peak hand impact force in forward fall. J Biomech 35:834–848CrossRefGoogle Scholar
  15. 15.
    DeGoede K, Ashton-Miller J, Schultz A, Alexander N (2002) Biomechanical factors affecting the peak hand reaction force during the bimanual arrest of a moving mass. J Biomech Eng 124:107–112Google Scholar
  16. 16.
    Duma S, Crandall J, Hurwitz S, Pilkey W (1998) Small female upper extremity interaction with a deploying side air bag. In: Proc. 42nd Stapp Car Crash Conf., SAE 983148Google Scholar
  17. 17.
    Duma S, Schreiber R, McMaster J, Crandall J, Bass C, Pilkey W (1998) Dynamic injury tolerances for long bones of the female upper extremity. In: Proc. IRCOBI Conf., S 189–201Google Scholar
  18. 18.
    Duma S, Boggess B, Crandall J, Hurwitz S, Seki K, Aoki T (2001) Analysis of upper extremity response under side air bag loading. In: Proc. 17th ESV Conf., Amsterdam, Paper No. 195Google Scholar
  19. 19.
    Duma S, Boggess B, Crandall J, Mac Mahon C (2002) Fracture tolerance of the small female elbow joint in compression: the effect of load angle relative to the long axis of the forearm. Stapp Car Crash J 46:195–210Google Scholar
  20. 20.
    Duma S, Cormier J, Hurst W, Stitzel J, Herring I (2003) The effects of seam design on airbag induced skin abrasions from high-rate shear loading. In: Proc. IRCOBI Conf., S 95–107Google Scholar
  21. 21.
    Frampton R, Morris A, Thomas P, Bodiwala G (1997) An overview of upper extremity injuries to car occupants in UK vehicle crashes. In: Proc. IRCOBI Conf., S 37–51Google Scholar
  22. 22.
    Giacobetti F, Sharkey P, Bos-Giacobetti M, Hume E, Taras J (1997) Biomechanical analysis of the effectiveness of in-line skating wrist guards for preventing wrist fractures. Am J Sports Med 25(2):223–225CrossRefGoogle Scholar
  23. 23.
    Goldman M, MacLennan P, McGwin G, Lee D, Sparks D, Rue L (2005) The association between restraint system and upper extremity injury after motor vehicle collisions. J Orthop Trauma 19(8):529–534CrossRefGoogle Scholar
  24. 24.
    Greenwald R, Janes P, Swanson S, McDonald T (1998) Dynamic impact response of human cadaveric forearms using a wrist brace. Am J Sports Med 26(6):825–830Google Scholar
  25. 25.
    Hardy W, Schneider L, Reed M, Ricci L (1997) Biomechanical investigation of airbag-induced upper-extremity injuries, SAE 973325. In: Proc. 41st Stapp Car Crash Conf., S 131–149Google Scholar
  26. 26.
    Hardy W, Schneider L, Rouhana S (2001) Prediction of airbag-induced forearm fractures and airbag aggressivity. Stapp Car Crash J 45:511–534Google Scholar
  27. 27.
    Huelke D, Gilbert R, Schneider L (1997) Upper-extremity injuries from steering wheel air bag deployments. SAE 970493Google Scholar
  28. 28.
    Hwang I, Kim K, Kaufman K, Cooney W, An K (2006) Biomechanical efficiency of wrist guards as a shock isolator. J Biomech Eng 128(2):229–234CrossRefGoogle Scholar
  29. 29.
    Kallieris D, Rizzetti A, Mattern R, Jost S, Priemer P, Unger M (1997) Response and vulnerability of the upper arm through side air bag deployment, SAE 973323. In: Proc. 41st Stapp Car Crash Conf., S 101–110Google Scholar
  30. 30.
    Keefe D, Lintner D (2004) Nerve injuries in the throwing elbow. Clin Sports Med 23:723–742CrossRefGoogle Scholar
  31. 31.
    Kim K, Ashton-Miller J (2003) Biomechanics of fall arrest using the upper extremity: age differences. Clin Biomech 18:311–318CrossRefGoogle Scholar
  32. 32.
    Kim K, Alian A, Moris W, Lee Y (2006) Shock attenuation of various protective devices for prevention of fall-related injuries of the forearm/hand complex. Am J Sports Med 34:637–643CrossRefGoogle Scholar
  33. 33.
    Kirkish S, Begeman P, Paravasthu N (1996) Proposed provisional reference values for the humerus for evaluation of injury potential. SAE 962416Google Scholar
  34. 34.
    Koh S, Cavanaugh J, Leach J, Rouhana S (2004) Mechanical properties of the shoulder ligaments under dynamic loading. Stapp Car Crash J 48:125–153Google Scholar
  35. 35.
    Kuppa S, Olson M, Yeiser C, Taylor L, Morgan R, Eppinger R (1997) RAID – an investigative tool to study air bag/upper extremity interactions. SAE 970399Google Scholar
  36. 36.
    Levine R (2002) Injuries to the extremities. In: Nahum M (Hrsg) Accidental injury – biomechanics and prevention. Springer, New YorkGoogle Scholar
  37. 37.
    Lewis L, West O, Standeven J, Jarvis H (1997) Do wrist guards protect against fractures? Ann Emerg Med 20:766–769CrossRefGoogle Scholar
  38. 38.
    Markolf K, Shapiro M, Mandelbaum B, Teurlings L (1990) Wrist loading patterns during pommel horse exercises. J Biomech 23(10):1001–1011CrossRefGoogle Scholar
  39. 39.
    McBain K, Shrier I, Shultz R, Meeuwisse W, Klügl M, Garza D, Matheson G (2012) Prevention of sports injury I: a systematic review of applied biomechanics and physiology outcomes research. Br J Sports Med 46:169–173CrossRefGoogle Scholar
  40. 40.
    McGrady L, Hoepfner P, Young C, Raasch W, Lim T, Han J (2001) Biomechanical effect of in-line skating wrist guards on the prevention of wrist fracture. Korean Soc Mech Eng Int J 150:1072–1076Google Scholar
  41. 41.
    McGwin G, Modjarrad K, Duma S, Rue L (2008) Association between upper extremity injuries and side airbag availability. J Trauma 64(5):1297–1301CrossRefGoogle Scholar
  42. 42.
    Messerer O (1880) Über Elasitzität und Festigkeit der menschlichen Knochen. Verlag der J. G. Cotta’schen Buchhandlung, StuttgartGoogle Scholar
  43. 43.
    Michel I, Schmitt KU, Greenwald R, Russell K, Simpson F, Schulz D, Langran M (2013) White paper: functionality and efficacy of wrist protectors in snowboarding – towards a harmonized international standard. Sports Eng, doi:10.1007/s12283-013-0113-3Google Scholar
  44. 44.
    Moore D, Popovic N, Daniel J, Boyea S, Polly D (1997) The effect of wrist brace on injury patterns in experimentally produced distal radial fractures in a cadaveric model. Am J Sports Med 25:394–401CrossRefGoogle Scholar
  45. 45.
    Pintar F, Yoganandan N, Eppinger R (1998) Response and tolerance of the human forearm to impact loading, SAE 983149. In: Proc. 42nd Stapp Car Crash Conf.Google Scholar
  46. 46.
    Rath A, Jernigan V, Stitzel J, Duma S (2005) The effects of depowered airbags on skin injuries in frontal automobile crashes. Plast Reconstr Surg 115(2):428–435CrossRefGoogle Scholar
  47. 47.
    Russel K, Hagel B, Francescutti L (2007) The effect of wrist guards on wrist and arm injuries amaong snowboarders: a systematic review. Clin J Sports Med 17:145–150CrossRefGoogle Scholar
  48. 48.
    Saul R, Backaitis H, Beebe M, Ore L (1996) Hybrid III dummy instrumentation and assessment of arm injuries during air bag deployment. In: Proc. 40th Stapp Car Crash Conf., SAE 962417, S 85–94Google Scholar
  49. 49.
    Schmitt KU, Michel F, Staudigl F (2012) Testing damping performance and bending stiffness of snowboarding wrist protectors. J ASTM Int (JAI) 9(4), Paper ID: JAI104204Google Scholar
  50. 50.
    Schmitt KU, Wider D, Michel F, Brügger O, Gerber H, Denoth J (2012) Characterizing the mechanical parameters of forward and backward falls as experienced in snowboarding. Sports Biomech 11(1):57–72CrossRefGoogle Scholar
  51. 51.
    Schneider L, Hardy W, Reed M (1998) Biomechanical investigation of airbag-induced forearm fractures. In: Proc. 3rd World Congress of Biomechanics, Sapporo, JapanGoogle Scholar
  52. 52.
    Schoenau E, Neu C, Rauch F, Manz F (2001) The development of bone strength at the proximal radius during childhood and adolescence. J Clin Endocrinol Metab 86(2):613–619CrossRefGoogle Scholar
  53. 53.
    Segui-Gomez M, Baker S (2002) Changes in injury patterns in frontal crashes: preliminary comparisons of drivers of vehicles model years 1993–1997 to drivers of vehicles 1998–2001. 46th Annual In: Proc, Association for the Advancement of Automotive Medicine, S 1–14Google Scholar
  54. 54.
    Snead D, Rettig A (2001) Hand and wrist fractures in athletes. Curr Opin Orthopaed 12:160–166CrossRefGoogle Scholar
  55. 55.
    Sobotta J (1997) Atlas der Anatomie des Menschen, Bd 1 & 2. Urban und Schwarzenberg, MünchenGoogle Scholar
  56. 56.
    Sokol Jafredo A, Potier P, Robin S, Le Coz J, Lassau J (1998) Upper extremity interaction with side impact airbag. In: Proc. IRCOBI Conf., S 485–495Google Scholar
  57. 57.
    Staebler M, Moore D, Akelman E, Weiss A, Fadale P, Crisco J 3rd (1999) The effect of wrist guards on bone strain in the distal forearm. Am J Sports Med 27(4):500–506Google Scholar
  58. 58.
    Törnvall F, Holmqvist K, Davidsson J, Svensson M, Haland Y, Öhrn H (2007) A new THOR shoulder design: a comparison with volunteers, the Hybrid III, and THOR NT. Traffic Inj Prev 8(2):205–215CrossRefGoogle Scholar
  59. 59.
    Törnvall F, Holmqvist K, Davidsson J, Svensson M, Gugler J, Steffan H, Haland Y (2008) Evaluation of dummy shoulder kinematics in oblique frontal collisions. In: Proc. IRCOBI Conf., S 195–210Google Scholar
  60. 60.
    Troy K, Grabiner M (2007) Off-axis loads cause failure of the distal radius at lower magnitudes than axial loads: a finite element analysis. J Biomech 40(8):1670–1675CrossRefGoogle Scholar
  61. 61.
    Weber C (1859) Chirurgische Erfahrungen und Untersuchungen. De Gruyter, BerlinGoogle Scholar
  62. 62.
    Whiting W, Zernicke R (1998) Biomechanics of musculoskeletal injury. Human Kinetics Pub., ChampaignGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Kai-Uwe Schmitt
    • 1
    Email author
  • Peter F. Niederer
    • 1
  • Duane S. Cronin
    • 2
  • Markus H. Muser
    • 3
  • Felix Walz
    • 3
  1. 1.Institut für biomedizinische TechnikUniversität und ETH ZürichZürichSchweiz
  2. 2.Department of Mechanical and Mechatronics EngineeringUniversity of WaterlooWaterlooCanada
  3. 3.AGU ZürichZürichSchweiz

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