Abstract
The definition of anatomical reference frames is necessary both for in vitro biomechanical testing, and for in vivo human movement analyses. Different reference frames have been proposed in the literature, for the different applications. Reference frames for in vivo use must rely on anatomical landmarks that can be accessed non-invasively in living subjects. This limits the operator to certain regions of the bone segments, and possibly to anatomical landmarks that are scarcely reproducible. Conversely, when the bone is fully accessible in vitro, direct measurements are possible of diameters, lengths, and angles. This enables the selection of anatomical reference planes that rely upon anatomical landmarks that are better reproducible. In this section, anatomical reference frames are discussed for the most important long bones of the human skeleton: femur, tibia, fibula, metatarsal bones, humerus, radius, ulna, metacarpal bones, and phalanges. The different reference frames proposed for each bone segment are discussed: this includes the guidelines proposed by the Standardization and Terminology Committee of the International Society of Biomechanics (ISB) for in vivo movement analysis, and also reference frames proposed by different authors for in vitro testing. Optimal reference frames are proposed for each bone segments. Detailed guidelines (including suggested materials and methods) are provided to correctly identify the anatomical landmarks and the anatomical frames. For each bone segment, an estimate of the intra-operator repeatability (i.e. when the same operator repeatedly identifies the reference frame on the same specimen) and of the inter-operator repeatability (i.e. when different operators identify the reference frame on the same specimen) is reported for the recommended reference frame. This confirms the reliability of the approach proposed.
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Abbreviations
- 3D:
-
Three-dimensional
- BLF:
-
Biomechanical length of the femur
- BLH:
-
Biomechanical length of the humerus
- BLR:
-
Biomechanical length of the radius
- BLT:
-
Biomechanical length of the tibia-fibula complex
- BLU:
-
Biomechanical length of the ulna
- CLT:
-
Landmark for the humerus: center of the most lateral part of the humeral trochlea
- CMT:
-
Landmark for the humerus: center of the most medial part of the humeral trochlea
- CT:
-
Computed tomography
- DFL:
-
Landmark for the femur: on the distal femoral diaphysis in the center of the concavity present on the anterior surface, proximal to the lateral epicondyle
- HF:
-
Landmark for the shank: apex of the head of the fibula
- IM:
-
Landmark for the shank: midpoint of the line joining MM and LM (coincides with MPM)
- ISB:
-
International Society of Biomechanics
- LC:
-
Landmark for the shank: most medial point on the edge of the lateral tibial condyle
- LFC:
-
Landmark for the femur: posterior side of the lateral femoral condyle
- LHDL:
-
Living Human Digital Library
- LM:
-
Landmark for the shank: apex of the lateral malleolus
- LTC:
-
Landmark for the tibia: centre of the lateral tibial condylar plateau
- MC:
-
Landmark for the shank: most medial point on the edge of the medial tibial condyle
- MFC:
-
Landmark for the femur: posterior side of the medial femoral condyle
- MM:
-
Landmark for the shank: apex of the medial malleolus
- MP:
-
Landmark for the tibia: medial point between MTC and LTC
- MPM:
-
Landmark for the shank: midpoint of the line joining MM and LM (coincides with IM)
- MTC:
-
Landmark for the tibia: centre of the medial tibial condylar plateau
- PFL:
-
Landmark for the femur: on the proximal diaphysis, center of a flat region immediately distal to the lesser trochanter
- SP:
-
Landmark for the radius: most distal point of the styloid process
- TAS:
-
Landmark for the tibia: centre of the talar articulation
- TN1, TN2, TN3:
-
Landmark for the ulna: three points in the trochlear notch in the proximal ulna
- TT:
-
Landmark for the shank: tibial tuberosity
- UN:
-
Landmark for the radius: central point of the ulnar notch
- VPH-OP:
-
Virtual Physiological Osteoporotic Human
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Acknowledgments
The authors wish to thank Massimiliano Baleani, Mateusz Juszczyk, and Serge Van Sint Jan for the stimulating discussions. Giorgia Conti, Valentina Danesi, and Paolo Erani greatly contributed to the development of the reference frames. Andrea Malandrino, Doriana Lionetti, and Caroline Öhman patiently contributed to the inter-operator variability assessment. Luigi Lena provided the artwork. Daniel Espino carefully revised the script.
The European Community co-funded this study (grants: IST-2004-026932 “Living Human Digital Library - LHDL” and #223865 “The Osteoporotic Virtual Physiological Human – VPHOP”).
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Cristofolini, L. (2012). Anatomical Reference Frames for Long Bones: Biomechanical Applications. In: Preedy, V. (eds) Handbook of Anthropometry. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1788-1_184
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DOI: https://doi.org/10.1007/978-1-4419-1788-1_184
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