中国临床解剖学杂志 ›› 2017, Vol. 35 ›› Issue (2): 203-206.doi: 10.13418/j.issn.1001-165x.2017.02.017

• 临床生物力学 • 上一篇    下一篇

软组织重建术治疗桡尺远侧关节不稳的生物力学研究

兰万利, 黄东, 邝艺臻, 左洁仪, 陈智颖, 蔡慧, 刘晓春   

  1. 南华大学教学医院广东省第二人民医院,  广州   510317
  • 收稿日期:2016-12-22 出版日期:2017-03-25 发布日期:2017-04-27
  • 通讯作者: 黄东,主任医师,教授,博士生导师,E-mail:dong-177@163.com
  • 作者简介:兰万利(1989-),男,湖南邵阳人,硕士,研究方向:创伤骨科,显微外科,E-mail:284143978@qq.com

Biomechanical study of soft tissue reconstruction in treatment of distal radioular joint instability

LAN Wan-li,HUANG Dong,KUANG Yi-zhen,ZUO Jie-yi, CHEN Zhi-ying, CAI Hui, LIU Xiao-chun   

  1. Guangdong No.2 People's Hospital,University of South China,Guangzhou 510317,China
  • Received:2016-12-22 Online:2017-03-25 Published:2017-04-27

摘要:

目的 比较2种软组织重建术式重建桡尺远侧关节稳定性的生物力学效果,为临床应用提供依据。  方法 选取8具成人上肢标本,通过制作损伤模型、模拟手术方式,比较正常组、损伤组、掌长肌腱组、桡侧腕屈肌组分别在腕背伸30°位、腕中立位、腕掌屈30°位时旋前、旋后时扭矩的变化。  结果 损伤组和正常组比较的旋前、旋后扭矩差异均有统计学意义(P>0.05);掌长肌腱组和正常组比较的差异无统计学意义;桡侧腕屈肌组在腕关节背伸30°、腕中立位时和正常组比较的旋前、旋后扭矩差异均无统计学意义,而在腕关节掌屈30°时的扭矩差异有统计学意义(P>0.05)。  结论 桡尺韧带损伤会造成桡尺远侧关节不稳,通过掌长肌腱移植重建后可恢复关节稳定性,而经过部分桡侧腕屈肌重建后,其在腕背伸30°和腕中立位时的稳定性得到恢复,但在腕掌屈30°时仍存在关节不稳。

关键词: 关节不稳, 桡尺韧带, 软组织重建术, 生物力学

Abstract:

Objective To compare the biomechanical effects of two soft tissue reconstruction procedures on the reconstruction of distal radioulnar joint stability, and to provide the basis for clinical application.    Methods Eight adult upper limb specimens were obtained, the injury model made and the operation mode simulated. The pronation and supination torque was compared among the normal group, injury group, palm long tendon group and flexor carpi radialis group when the wrist was located at dorsiflexion 30°, neutral position and flexion 30°. Results There was significant difference in pronation and supination torque between the normal group and injury group (P>0.05). The difference between the normal group and palm long tendon group was not statistically significant. There was no statistically significant difference of torque between the normal group and  flexor carpi radialis group when the wrist was located at dorsiflexion 30 ° and neutral position,but was statistically significant at flexion 30° (P>0.05). Conclusion Radioulnar ligament injury can cause instability of the distal radioulnar joint. The reconstruction of the radioulnar ligament can restore the stability of the joint with the palmaris tendon graft. After the ligament reconstruction with transposition of the partial flexor carpi radialis, the stability of the wrist in dorsiflexion 30 °and neutral position was restored, but in flexion 30 ° when there is still joint instability.

Key words: Joint instability, Radioulnar ligament, Soft tissue reconstruction, Biomechanics