正常腕骨三维运动学的在体研究

In vivo study of 3D-Kinematics of the normal carpus

目的探讨正常腕关节在屈伸、桡尺偏运动时各腕骨的三维运动学。方法选健康志愿者10名,在各种体位下行腕关节CT扫描后,在自行开发的外科手术模拟系统内三维重建,计算出各腕骨的质心、转动惯量轴,在桡骨建立参照坐标系,用有限螺旋轴表达各腕骨相对于桡骨远端的旋转及平移运动。结果腕关节在冠状面运动时各腕骨有较大的非平面运动,腕关节在矢状面运动时各腕骨运动主要为屈伸运动,非平面运动较小。远排腕骨运动学相近,可视为一个整体;近排腕骨运动相差较大。结论腕关节在屈-伸和桡-尺偏时各腕骨的运动是三维的,并不是传统的横排和纵列的单一运动模式。该研究的结果与过去文献资料报道相似,为在体研究腕骨三维运动学分析提供了一定的理论及技术参考。

Objective To accurately quantify three-dementional in vivo kinematics of all carpal bones in wrist flexion and extention and radial and ulnar deviation. Methods The right wrists of 10 healthy adult volunteers were imaged by spiral CT at various wrist positions. The centroid and moments of inertia and finite helical axis carpal calculated, the 3D coordinate system and the 3D measurement can be performed in our computer-operated simulation system. The 3D carpal bones kinematics which is referred to distal radius can be gained. Results During wrist moving in the coronal plane, every carpal bones have un-plane motion except for coronal plane motion. During wrist moving in the vertical plane, the major motion of every carpal is flexion-extention, but un-plane motion is little. The motion of distal row of carpal bones is similar as a rigid body , but the proximal one is significantly different from each other. Conclusions All the carpal bones kinematics are three-dimensional direction during wrist flexion-extention motion and ulnar-radial deviation. A single functional mode of carpal kinematics such as the fixed-row and the columns concept could not be determined. Our results are in concordance with previous published data in vitro and in vivo. The study sufficiently provides some theoretic and technical references for in vivo studies on 3D carpal kinematics.