摘要
目的:较大运动强度对腕关节头-月-三角-钩骨四角融合体稳定性究竟有何影响,国内外尚无报道。分析腕关节极限运动与四角融合体稳定性的关系。方法:实验于2005-03/2006-03在南通大学骨科生物力学实验室完成。选用12具未经防腐处理的新鲜尸体肘关节以远标本,切断桡舟月韧带、舟月骨间韧带掌侧部分、舟月骨间韧带背侧部分、桡舟头韧带,建立腕关节不稳定模型后,进行头-月-三角-钩骨四角融合术。融合腕模拟屈、伸、尺偏及桡偏运动,腕关节在安全活动范围内从0°开始,每5°1个等级,每个方向分别施以5万次极限运动。每次运动前后均摄标准前后位及侧位片,测量前后位片融合体高度、融合体宽度、头月正位角及侧位片桡月角、头月角并观察克氏针松动及弯曲情况。所有腕关节均采用运动前后自身对照。结果:①当腕关节屈曲至35°、背伸至25°、桡偏10°、尺偏15°时,极限运动对融合体的稳定性无影响,未出现融合体的解体。②当腕关节屈曲至40°、背伸至30°时,头月角、桡月角及融合体高度与0°相比差异具有显著性意义(P<0.05);当桡偏至15°、尺偏至20°时,融合体的稳定性受到影响,头月正位角、融合体宽度与0°相比差异具有显著性意义(P<0.01)。③克氏针弯曲的临界值:平均在屈曲至43.3°、背伸至32.5°、尺偏至23.3°、桡偏至15.8°时克氏针弯曲。结论:极限运动时,在掌屈40°、背伸30°、桡偏15°、尺偏20°的范围内进行功能锻炼,不会影响四角融合体的稳定性,但应避免环转运动。
AIM: There is no report about the effect of high-intensity exercise on the stability of articular head-lunate bone-triangular bone-hamate bone four-comer arthrodesis. In this study, the correlation between maximal exercise of wrist joint and the stability of four-comer arthrodesis was explored. METHODS: The experiment was carded out in the laboratory of biomechanics, Department of Orthopedics, Nantong University from March 2005 to March 2006. Twelve fresh cadaveric fore arms were selected as samples. After the radial scapholunate ligament (RSL), palmar scapholunate interosseous ligaments (PSLIL), dorsal scapholunate interosseous ligament (DSLIS) and radial scahpocapitate ligament (RSC) were cut off to establish models of joint instability, the four-comer arthrodesis was performed. Then, the wrist simulated flexion, extension, ulnar deviation and radial deviation exercise with the motion range from 0° every 5° as one grade for 50 000 times. Anteropostedor and lateral radiographs were taken before and after the motion. The height and width of the syzygium, captiolunate posteroanterior angle, capitolunate (CL) angle and radiolunate (RL) angle were measured; Kirschner wire loosening and flexing was observed. Wdst joint before and after exercise served as self control. RESULTS: (1)When the wrist joint was 35° flexion, 25° extension, 10 °radial deviation and 15° ulnar deviation, the stability of arthrodesis was not influenced by maximal exercise. (2)Compared to the control group, the CL angle, RL angle and the height of syzygium showed statistical significance when flexion 40° and extension 30° (P 〈 0.05); Accordingly, the captiolunate posteroanterior angle, and the width of syzygium showed statistical significance when radial deviation 15° and ulnar deviation 20° (P 〈 0.01). (3)Kirschner wire bended at 43.3° flexion, 32.5° extension, 23.3° ulnar deviation and 15.8° radial deviation. CONCLUSION: It is safe to do the functional exercise ranging in flexion 40°, extension 30°, ulnar deviation 20°, and radial deviation 10°, but circumduction should be avoided.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第49期9855-9858,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
江苏省"135"工程重点医学人才基金(RC2003-101)~~