Shoulder impact response and injury due to lateral and oblique loading

Little is known about the response of the shoulder complex due to lateral and oblique loading. Increasing this knowledge of shoulder response due to these types of loading could aid in improving the biofidelity of the shoulder mechanisms of anthropomorphic test devices (ATDs). The first objective of this study was to define force versus deflection corridors for the shoulder corresponding to both lateral and oblique loading. A second focus of the shoulder research was to study the differences in potential injury between oblique and lateral loading. These objectives were carried out by combining previously published lateral impact data from 24 tests along with 14 additional recently completed lateral and oblique tests. The newly completed tests utilized a pneumatic ram to impact the shoulder of approximately fiftieth percentile sized cadavers at the level of the glenohumeral joint with a constant speed of approximately 4.4 m/sec. Of the 14 tests, four of them were conducted lateral to the shoulder along the subject's y-axis, four of them were conducted 15 anterior to this axis, and six were conducted 30 anterior to the subject's y-axis. As in the previous testing, the first thoracic vertebrae and both shoulders of the subject were instrumented with tri-axial linear accelerometers on the sternum, clavicle, acromion process, and inferior angle of the scapula. The impacting mass was instrumented with an accelerometer and displacement transducer. In addition to this instrumentation, the tests were documented by high-speed digital imagery. Radiographs (x-rays), magnetic resonance images (MRIs), and autopsies were used to document injury to the subjects. The results from the tests revealed differences between the stiffness of the shoulder when loaded laterally to that when it is loaded obliquely. The shoulder was found to deflect twice as much medially when loaded obliquely then when it is loaded laterally. This can be attributed to the ability of the scapula to slide posteriorly around the thoracic cage. The ability of the shoulder to displace medially while simultaneously deflecting posteriorly in oblique impact is important to replicate in the ATDs because it results in the load being transmitted to the upper thoracic cage.