近节指骨滑车损伤对近指间关节侧方稳定性影响的应用解剖学研究

doi:10.13418/j.issn.1001-165x.2021.06.002

中国临床解剖学杂志 ›› 2021, Vol. 39 ›› Issue (6): 635-637.doi: 10.13418/j.issn.1001-165x.2021.06.002

近节指骨滑车损伤对近指间关节侧方稳定性影响的应用解剖学研究

王少和¹，　范红斌¹，　史关祺²，　陈杨澍²，　高娣²
金哲悟¹，　王真¹，　杜斌¹，　胡一波¹，　吴柯³

1.江南大学无锡医学院人体解剖与组织胚胎学教研室，江苏无锡 214122； 2.江南大学无锡医学院2020级
临床医学本科，江苏无锡 214122； 3.苏州大学附属无锡市第九人民医院，江苏无锡 214062

收稿日期:2021-07-04 出版日期:2021-11-25 发布日期:2021-12-01
通讯作者: 吴柯，副主任医师，E-mail：wkkirk@yeah.net
作者简介:王少和（1994-），男，江苏无锡人，研究方向：人体解剖学，E-mail：8202008376@jiangnan.edu.cn
基金资助:
江苏省博士后科研资助计划（2020Z359）

Applied anatomical study of the lateral stability of proximal interphalangeal joint by the injury of proximal phalanx trochlea

Wang Shaohe¹, Fan Hongbin¹, Shi Guanqi², Chen Yangshu², Gao Di², Jin Zhewu¹, Wang Zhen¹, Du Bin¹, Hu Yibo¹, Wu Ke³

1. Department of Human Anatomy and Histology, Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China；2. Grade 2020 Clinical Medicine, Wuxi School of Medicine, Jiangnan University, Wuxi 214122, China；3. Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi 214062, China

Received:2021-07-04 Online:2021-11-25 Published:2021-12-01

摘要/Abstract

摘要： 目的　通过近节指骨滑车损伤实验，探究其对近指间关节侧方稳定性影响，为治疗提供解剖依据。方法　解剖6具成人双上肢手标本，选择示指、中指、环指共36只手指进行研究。分别测量0 °屈曲位时近指间关节近节指骨滑车未损伤及桡侧损伤10%、20%、30%、40%、50%的桡偏角度。结果　未损伤时近节指骨滑车两端长度平均为（10.25±1.12）mm，桡偏角度为（0.14±0.10）°，损伤10%时桡偏角度为（5.06±0.53）°，损伤20%时桡偏角度为（8.47±0.42）°，损伤30%时桡偏角度为（12.28±0.71）°，损伤40%时桡偏角度为（16.33±0.76）°，损伤50%时桡偏角度为（20.03±0.75）°。近节指骨滑车损伤程度越重，近指间关节桡偏角度越大，关节稳定性越差（P<0.0001，Wilcoxon检验）。结论　近节指骨滑车缺损对近指间关节侧方稳定性具有显著影响，损伤达10%时即可发生侧方不稳定。

关键词: 近节指骨滑车, 　近指间关节, 　稳定性, 　应用解剖

Abstract: Objective　To provide anatomical basis for the treatment of proximal interphalangeal (PIP) joint by the injury experiment of proximal phalanx trochlea.　Methods　Both of the upper hand specimens from 6 adults were dissected, and 36 fingers including index finger, middle finger and ring finger were selected for the study. The radial angle of PIP joints was measured when the trochlea of proximal phalanx was intacted 10%, 20%, 30%, 40% and 50% of injuries at 0 ° PIP joint flexion. 　Results　The mean length of the two sides of the proximal phalanx was (10.25±1.12) mm, and the radial angle of PIP joints was (0.14±0.10) °. When 10% of injuries, it was (5.06±0.53) °, when 20% of injuries, it was (8.47±0.42) °, when 30% of injuries, it was (12.28±0.71) °, when 40% of injuries, it was (16.33±0.76) °, and when 50% of injuries, it was (20.03±0.75) °. The more severe the injury of the proximal phalanx trochlea, the larger the radial angle of PIP joints, meaning the more unstable the PIP joints (P<0.0001, Wilcoxon test).　Conclusions　The defect of the proximal phalangeal trochlea has a significant effect on the lateral stability of PIP joints. Lateral instability can occur when the injury reaches 10%.

Key words: Proximal phalangeal trochlea, 　Proximal interphalangeal joint, 　Stability, 　Applied anatomy

中图分类号:

王少和, 范红斌, 史关祺, 陈杨澍, 高娣, 金哲悟, 王真, 杜斌, 胡一波, 吴柯. 近节指骨滑车损伤对近指间关节侧方稳定性影响的应用解剖学研究[J]. 中国临床解剖学杂志, 2021, 39(6): 635-637.

Wang Shaohe, Fan Hongbin, Shi Guanqi, Chen Yangshu, Gao Di, Jin Zhewu, Wang Zhen, Du Bin, Hu Yibo, Wu Ke. Applied anatomical study of the lateral stability of proximal interphalangeal joint by the injury of proximal phalanx trochlea[J]. Chinese Journal of Clinical Anatomy, 2021, 39(6): 635-637.

参考文献 11

[1]	Cheah AEJ, Yao J. Hand fractures: indications, the tried and true and new innovations[J]. J Hand Surg Am, 2016, 41(6): 712-722. DOI: 10.1016/j.jhsa.2016.03.007.
[2]	赵文韬, 赵民. 手指伸肌腱Ⅰ区肌腱末节指骨止点与毗邻组织的应用解剖学研究[J]. 中国临床解剖学杂志, 2021, 39(2): 126-129. DOI: 10.13418/j.issn.1001-165x.2021.02.002.
[3]	汤样华, 黄小华, 曾林如, 等. 矩形钢板固定治疗近节指骨中远段骨折的疗效分析[J]. 中华手外科杂志, 2018, 34(5): 387-388. DOI: 10.3760/cma.j.issn.1005-054X.2018.05.024.
[4]	Tyser AR, Tsai MA, Parks BG, et al. Stability of acute dorsal fracture dislocations of the proximal interphalangeal joint: a biomechanical study[J]. J Hand Surg Am, 2014, 39(1): 13-18. DOI: 10.1016/j.jhsa.2013.09.025.
[5]	Buncke HJ Jr, Daniler AI, Schulz WP, et al. The fate of autogenous whole joints transplanted by microvascular anastomoses[J]. Plast Reconstr Surg, 1967, 39(4): 333-341. DOI: 10.1097/00006534-196704000-00001.
[6]	谢山洪, 熊革, 郑炜, 等. 半钩骨移植结合伸肌腱松解治疗陈旧性中节指骨掌侧基底骨折合并近指间关节脱位的临床经验[J]. 中华损伤与修复杂志(电子版), 2020, 15(5): 355-358. DOI: 10.3877/cma.j.issn.1673-9450.2020.05.006.
[7]	林东鑫, 何藻鹏, 苏炜炜, 等. 3D打印技术在指关节缺损的应用研究进展[J]. 中国医学物理学杂志, 2021, 38(2): 250-253. DOI: 10.3969/j.issn.1005-202X.2021.02.022.
[8]	Trumble TE, Heaton DJ. Outcomes of surface replacement proximal interphalangeal joint arthroplasty through a volar approach: a prospective study[J]. Hand (N Y), 2017, 12(3): 290-296. DOI: 10.1177/1558944716662020.
[9]	Van Nuffel M, Degreef I, Willems S, et al. Proximal interphalangeal joint replacement: resurfacing pyrocarbon versus silicone arthroplasty[J]. Acta Orthop Belg, 2014, 80(2): 190-195. DOI: 10.1016/j.jphys.2014.03.003.
[10]	Tägil M, Geijer M, Abramo A, et al. Ten years' experience with a pyrocarbon prosthesis replacing the proximal interphalangeal joint. A prospective clinical and radiographic follow-up[J]. J Hand Surg Eur, 2014, 39(6): 587-595. DOI: 10.1177/1753193413479527.
[11]	Li C, Cheung TF, Fan VC, et al. Applications of three-dimensional printing in surgery[J]. Surg Innov, 2017, 24(1): 82-88. DOI: 10.1177/1553350616681889.

[1]	陈仁, 杨胜波. 咬肌的解剖与临床应用研究进展[J]. 中国临床解剖学杂志, 2024, 42(1): 115-117.
[2]	吴文斌, 胡雨田, 代琳曦, 吕旺轩, 吕丰均, 尹袁杰, 杨红梦, 畅君达, 李文奇, 郭义威. 椎神经节麻醉的应用解剖学研究[J]. 中国临床解剖学杂志, 2023, 41(6): 640-646.
[3]	白继岳, 徐永清. 周围神经选择性部分切断术治疗脑性瘫痪的解剖学研究进展[J]. 中国临床解剖学杂志, 2023, 41(6): 754-756.
[4]	何晓清, 杨曦, 石岩, 徐月仙, 方翔, 范新宇, 吴亚玲, 徐永清. 腓肠外侧浅动脉穿支皮瓣术中解剖学观察及临床意义[J]. 中国临床解剖学杂志, 2023, 41(2): 132-136.
[5]	陈帅, 易陈鹏, 王杰, 宫大伟, 焦峰, 黄华扬, 郑小飞, 王海彬. 胫侧副韧带与内侧半月板的关系解剖研究及临床意义[J]. 中国临床解剖学杂志, 2022, 40(5): 519-522.
[6]	朱明昇, 王增涛, 陈京国, 郝丽文, 陈超, 侯致典. 第1掌心动脉掌骨颈尺侧穿支的解剖研究及临床意义[J]. 中国临床解剖学杂志, 2022, 40(3): 249-254.
[7]	童杰, 季伟, 黄志平, 周若舟, 房佐忠, 朱青安. 枕颈区后路柔性动态固定的生物力学研究[J]. 中国临床解剖学杂志, 2022, 40(3): 315-319.
[8]	周家宇, 周国燕, 杨胜波. 成人前臂前群肌的神经入肌点定位及意义[J]. 中国临床解剖学杂志, 2022, 40(2): 126-131.
[9]	刘兴利, 杜自宏, 张湘敏, 尹俊琨, 付杜娟, 李治, 吕梁. 基于血管显像仪的右上肢肘窝区浅静脉应用解剖研究[J]. 中国临床解剖学杂志, 2021, 39(3): 269-275.
[10]	赵文韬, 赵民. 手指伸肌腱Ⅰ区肌腱末节指骨止点与毗邻组织的应用解剖学研究[J]. 中国临床解剖学杂志, 2021, 39(2): 126-129.
[11]	孙诗竹, 　于胜波, 　隋鸿锦. P45断层塑化技术在应用解剖学研究中的应用[J]. 中国临床解剖学杂志, 2021, 39(2): 240-243.
[12]	胡婕, 邹文静, 王韵婷, 牛超, 符州, 代继宏. 经口气管插管激发和雾化激发建立哮喘小鼠模型的比较[J]. 中国临床解剖学杂志, 2021, 39(1): 65-70.
[13]	田维东, 彭龙锋, 祝绍磊, 王孝文. 小脑动脉与三叉神经根毗邻关系的应用解剖[J]. 中国临床解剖学杂志, 2020, 38(6): 625-628.
[14]	陈韦东, 钱蕾, 瞿东滨, 贺善礼, 李泽宇, 谭炜浩, 钟锦涛, 杨航, 欧阳钧, 郑明辉. 胸椎旁神经阻滞术穿刺深度的解剖学研究[J]. 中国临床解剖学杂志, 2020, 38(5): 545-548.
[15]	姜铧财, 龙雳, 李森. 高位髂腹股沟入路治疗Tile C型骨盆骨折的应用解剖及临床疗效[J]. 中国临床解剖学杂志, 2020, 38(4): 471-475.

近节指骨滑车损伤对近指间关节侧方稳定性影响的应用解剖学研究

Applied anatomical study of the lateral stability of proximal interphalangeal joint by the injury of proximal phalanx trochlea

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献 11

相关文章 15

Metrics

本文评价

推荐阅读 0