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This study investigates the biomechanical mechanisms underlying elbow dislocation, emphasizing the role of flexion angle and forearm rotation on joint stability. Simulating realistic fall dynamics and injury conditions remains a major challenge in experimental biomechanics, and this work addresses that gap through controlled in vitro testing and computational modeling. Seventy Papio anubis (baboon) and twenty-one human cadaveric arms were tested under axial and hyperextension loading conditions to evaluate dislocation thresholds and ligament failure sequences. These trials indicate that maintaining bone integrity and soft-tissue support may restore elbow stability through severalnonsurgical strategies. Across both models, dislocation resistance increased with elbow flexion and was significantly greater in pronation compared to supination. The results demonstrate that maintaining bony congruence and soft-tissue integrity substantially enhances stability and that complete dislocation typically requires combined ligament rupture and bony failure. Across 0°–45° of flexion, Stage III dislocation thresholds reached approximately 1.9–2.2 kN in pronation versus 0.8–1.0 kN in supination for Papio anubis , closely matching the human mean of 1.94 kN. Finite-element simulations confirmed these patterns, revealing stress localization at the coronoid process and radial head consistent with early-stage dislocation. The results highlight the translational relevance of the baboon model for studying human elbow instability and provide a validated framework for future surgical and rehabilitation strategies. These findings advance the mechanical understanding of elbow instability and emphasize how forearm orientation and flexion angle influence load distribution, ligament strain, and the sequence of failure.
Kork et al. (Thu,) studied this question.