中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2010年
7期
664-667
,共4页
顾晓坤%徐静%汤锦波%顾剑辉
顧曉坤%徐靜%湯錦波%顧劍輝
고효곤%서정%탕금파%고검휘
腕关节%韧带%运动%活体研究
腕關節%韌帶%運動%活體研究
완관절%인대%운동%활체연구
Carpal joints%Ligaments%Movement%In vivo study
目的 探讨腕关节在投掷运动过程中腕关节韧带长度的变化.方法 对6例志愿者腕关节进行CT扫描,获取腕关节在投掷运动过程中的5个位置,即桡偏20°背伸60°,桡偏10°背伸30°,中立位,尺偏20°掌屈30°,尺偏40°掌屈60°时各腕骨、尺桡骨远段的三维重建图像,在重建图像基础上利用Mimics软件测得在腕关节投掷运动过程中掌、背侧腕关节韧带的长度.结果 腕关节由中立位至桡偏20°背伸60°时桡舟头韧带、长桡月韧带、尺头韧带、尺三角韧带长度显著伸长,分别延长(3.4±0.5)、(2.0±0.2)、(2.6±0.5)、(2.1±0.4)mm,差异均有统计学意义(P<0.05);腕关节由中立位至尺偏400掌屈60°时背侧桡腕韧带、背侧骨间韧带止于小多角骨部分长度显著伸长,分别延长(1.7 ±0.2)、(3.8 ±0.4)mm,差异有统计学意义(P<0.05).尺月韧带、背侧骨问韧带止于舟骨部分在投掷运动过程中其长度均较中立位时旱增长趋势.结论 腕关节在桡背伸至尺掌屈运动过程中,桡舟头韧带、长桡月韧带、尺头韧带、尺三角韧带缩短,提示张力减低,背侧桡腕韧带、背侧骨间韧带止于小多角骨部分伸长,张力增大,尺月韧带、背侧骨间韧带止于舟骨部分于中立位时张力最小,其变化规律有助于指导临床腕关节韧带损伤的修复.
目的 探討腕關節在投擲運動過程中腕關節韌帶長度的變化.方法 對6例誌願者腕關節進行CT掃描,穫取腕關節在投擲運動過程中的5箇位置,即橈偏20°揹伸60°,橈偏10°揹伸30°,中立位,呎偏20°掌屈30°,呎偏40°掌屈60°時各腕骨、呎橈骨遠段的三維重建圖像,在重建圖像基礎上利用Mimics軟件測得在腕關節投擲運動過程中掌、揹側腕關節韌帶的長度.結果 腕關節由中立位至橈偏20°揹伸60°時橈舟頭韌帶、長橈月韌帶、呎頭韌帶、呎三角韌帶長度顯著伸長,分彆延長(3.4±0.5)、(2.0±0.2)、(2.6±0.5)、(2.1±0.4)mm,差異均有統計學意義(P<0.05);腕關節由中立位至呎偏400掌屈60°時揹側橈腕韌帶、揹側骨間韌帶止于小多角骨部分長度顯著伸長,分彆延長(1.7 ±0.2)、(3.8 ±0.4)mm,差異有統計學意義(P<0.05).呎月韌帶、揹側骨問韌帶止于舟骨部分在投擲運動過程中其長度均較中立位時旱增長趨勢.結論 腕關節在橈揹伸至呎掌屈運動過程中,橈舟頭韌帶、長橈月韌帶、呎頭韌帶、呎三角韌帶縮短,提示張力減低,揹側橈腕韌帶、揹側骨間韌帶止于小多角骨部分伸長,張力增大,呎月韌帶、揹側骨間韌帶止于舟骨部分于中立位時張力最小,其變化規律有助于指導臨床腕關節韌帶損傷的脩複.
목적 탐토완관절재투척운동과정중완관절인대장도적변화.방법 대6례지원자완관절진행CT소묘,획취완관절재투척운동과정중적5개위치,즉뇨편20°배신60°,뇨편10°배신30°,중립위,척편20°장굴30°,척편40°장굴60°시각완골、척뇨골원단적삼유중건도상,재중건도상기출상이용Mimics연건측득재완관절투척운동과정중장、배측완관절인대적장도.결과 완관절유중립위지뇨편20°배신60°시뇨주두인대、장뇨월인대、척두인대、척삼각인대장도현저신장,분별연장(3.4±0.5)、(2.0±0.2)、(2.6±0.5)、(2.1±0.4)mm,차이균유통계학의의(P<0.05);완관절유중립위지척편400장굴60°시배측뇨완인대、배측골간인대지우소다각골부분장도현저신장,분별연장(1.7 ±0.2)、(3.8 ±0.4)mm,차이유통계학의의(P<0.05).척월인대、배측골문인대지우주골부분재투척운동과정중기장도균교중립위시한증장추세.결론 완관절재뇨배신지척장굴운동과정중,뇨주두인대、장뇨월인대、척두인대、척삼각인대축단,제시장력감저,배측뇨완인대、배측골간인대지우소다각골부분신장,장력증대,척월인대、배측골간인대지우주골부분우중립위시장력최소,기변화규률유조우지도림상완관절인대손상적수복.
Objective To investigate changes in wrist ligament length when the wrist is in different throwing positions.Methods Six wrists of 6 volunteers were enrolled in the experiment to obtain CT scans at 5 throwing positions of the wrist:20 degrees of radial deviation with 60 degrees of extension,10 degrees of radial deviation with 30 degrees of extension,neutral,20 degrees of ulnar deviation with 30 degrees of flexion,and 40 degrees of ulnar deviation with 60 degree of flexion.The carpal and distal radioulnar joint structures were reconstructed 3-dimensionally with customized software.Changes in length of the palmar and dorsal wrist ligaments in throwing motion were computed with the software. Results From wrist radial deviation with extension to ulnar deviation with flexion,the lengths of the radioscaphocapitate(RSC)ligament.the long radiolunate ligament(LRL),the ulnoceapitate ligament(UC)and the ulnotriquetral ligament (UT)decreased significantly(P<0.05),but the lengths of dorsal radiocarpal ligament(DRC)and the dorsal interearpal ligament(DIC)inserting on the trapezoid increased significantly(P<0.05).The lengths of ulnolunate ligament(UL)and the dorsal interearpal ligament inserting on the seaphoid were the shortest when the wrist was in the neutral position. Conclusions At wrist ulnar deviation with flexion,the RSC,LRL.UC and UT ligaments are slack.At wrist radial deviation with extension.the DRC ligament and the dorsal intercaroal ligament inserrting on the trapezoid are slack.The UL ligament and the dorsal intercarpal ligament inserting on the seaphoid are the slackest in the neutral position.These positions may be favorable to the healing of these ligaments.
