桡骨短缩对桡腕关节影响的生物力学研究

Effects of radial shortening on wrist joint: a biomechanical study

目的:研究桡骨远端骨折后桡骨短缩对桡腕关节的影响。方法:12只成人上肢标本于距关节面3 cm处截骨去除1 cm骨块,使骨块可向近端移动,制作桡骨远端骨折后桡骨短缩模型,利用压敏片测试桡腕关节面的应力分布和受力面积改变情况。结果:随着桡骨短缩的增加,舟骨的接触面积无显著变化(P>0.01),接触应力显著增大(P<0.01);月骨的接触面积轻度增加,接触应力显著增大(P<0.01),桡骨短缩≥4 mm时即有显著变化,桡骨短缩≥4-6 mm造成尺骨撞击三角骨。结论:桡骨远端骨折短缩4 mm以上时,接触应力有显著变化,影响腕关节功能。

Objective:To investigate the effects of radial shortening in distal radius fractures on wrist joint. Methods: 12 upper extremity specimens were transected at the mid-humeral level. Radial shortening of distal radius fracture malunion was simulated in the following way: resecting approximately 1.0cm of the radius 3cm proximal to the distal radioulnar joint. Pressure-sensitive film was applied to study the changes of the stress distribution on contact area and the pressure loaded across the radiocarpal joint. Results: With the increasing of the length of radial shorenting (RS), the contact pressure of lunate significantly increased, while the contact pressure of scaphoid decreased obviously. Conclusions:It appears that the most significant effect on contact stress of the radiocarpal joint occurs with a 4mm radial shortening (RS) or more, and lead to significantly effect on wrist joint.