CAJ | 학술논문

目的研究腕关节屈伸运动时舟月骨间韧带(scapholunate interosseous ligament,SLIL)及其各亚区分级切断后对舟、月骨三维运动的影响,从亚区水平对SLIL在舟、月骨三维运动中的作用进行研究.方法取12例新鲜冰冻成人上肢标本(左、右侧各6例),分为正常组、断SLIL近侧组、断SIIL近侧+背侧组、断SLIL近侧+掌侧组、SLIL全断组(每组6例),采用三维激光扫描及图像重建技术测定在腕关节屈伸运动时舟、月骨的三维运动数据,并进行统计学分析.结果正常腕关节在做屈伸运动时,舟月骨的活动方向与腕关节一致,但活动幅度不同,舟骨的活动范围要大于月骨的活动范围.同时,舟月骨还伴有尺桡偏(主要是桡偏)及轻度的旋前旋后活动.切断近侧+掌侧或近侧+背侧亚区组,会对舟月骨的三维运动产生影响.全切断SLIL会导致舟骨掌屈度增加,月骨掌屈活动减弱.结论采用三维激光扫描及图像重建技术可准确测定腕舟月骨的三维活动度.在SLIL亚区水平上进行的研究表明,部分或全部切断SLIL会对舟月骨的屈伸运动产生明显影响,但SLIL近侧亚区在控制舟月骨运动中不起主要作用.
목적 연구완관절굴신운동시주월골간인대(scapholunate interosseous ligament,SLIL)급기각아구분급절단후대주、월골삼유운동적영향,종아구수평대SLIL재주、월골삼유운동중적작용진행연구.방법 취12례신선빙동성인상지표본(좌、우측각6례),분위정상조、단SLIL근측조、단SIIL근측+배측조、단SLIL근측+장측조、SLIL전단조(매조6례),채용삼유격광소묘급도상중건기술측정재완관절굴신운동시주、월골적삼유운동수거,병진행통계학분석.결과 정상완관절재주굴신운동시,주월골적활동방향여완관절일치,단활동폭도불동,주골적활동범위요대우월골적활동범위.동시,주월골환반유척뇨편(주요시뇨편)급경도적선전선후활동.절단근측+장측혹근측+배측아구조,회대주월골적삼유운동산생영향.전절단SLIL회도치주골장굴도증가,월골장굴활동감약.결론 채용삼유격광소묘급도상중건기술가준학측정완주월골적삼유활동도.재SLIL아구수평상진행적연구표명,부분혹전부절단SLIL회대주월골적굴신운동산생명현영향,단SLIL근측아구재공제주월골운동중불기주요작용.
Objective To observe the resection of the scapholunate interosseous ligament (SLIL)and its subregions on the three-dimensional(3-D)movement of the scaphoid and lunate so as to discuss the role of SLIL in the 3D flexion-extension motion of the scaphoid and lunate.Methods Twelve upper extremities(six left extremities and six right extremities)from adult cadaver were used in this study and divided into five groups:normal group,proximal subregion resection group,proximal subregion plus dorsal subregion resection group,proximal subregion plus palmar subregion resection group and whole SLIL resection group.The 3-D laser scan and reconstruction technique were used for meusure ment of the 3-D flexion-extension motion of the scaphoid and lunate.Results In the normal group,the scaphoid and lunate flexed and the radial deviated at the same direction during wrist flexion-extension motion.At the same time,there was minimal scaphoid and lunate pronation-supination during wrist flexionextension.After resection of the proximal and palmar(or dorsal)subregions of the SLIL,some different movements were found compared with the normal specimen.Whole SLIL resection resulted in increase of the flexion motion of the scaphoid but decrease of the palmar flexion of the lunate.Conclusions 3-D laser scanning and image reconstruction techniques can accurately measure the 3D motion of the scaphoid and lunate.Partial or whole resection of SLIL may exert significant effect on the flexion-extension motion of the scaphoid and lunate.However,the proximal subregion of SLIL has no prominent effect on the motion of the scaphoid and lunate.