屈指肌腱鞘滑车系统的生物力学研究

A biomechanical study of the pulley system on the flexor tendon sheath

目的：比较各滑车作用的大小，为临床滑车重建提供依据。方法；通过改进实验装置和采用新的衡量指标—屈曲功丧失率，对１１只冰冻新鲜手的３３个手指分别切除和保留不同的滑车进行了生物力学测试。结果：单独切除各滑车以Ａ２屈曲功丧失率最大（９．５６％），与其它滑车单独切除相比相差显著（Ｐ＜０．０５）；切除交叉滑车的屈曲功丧失失率与对照（不切任何滑车）差异无显著性（Ｐ＞０．０５）；单独保留一个滑车时，以Ａ２滑车的屈曲功丧失率最小（１９．６３％），保留两个滑车，以Ａ２－Ａ４的屈曲功丧失率最小（１３．５８％），只保留三个滑车以Ａ２－Ａ３－Ａ４的屈曲功丧失率最小（９．３２％）。结论：Ａ２滑车的单独作用最大，其次是Ａ４，滑车作用大小的排序是：Ａ２、Ａ４、Ａ３、Ａ１、ＰＡ、Ａ５。

Objective:To reveal the morphological characteristics of the pulley system,and provide anatomy basis for clinical pulley reconstruction.Methods:33 digits of 11 fresh frozen hands were studied biomechanically with or without the pulley.An improved experimental device and a new parameter,percentage loss of work (PLW) were used in this study.Results:When only one pulley was excised at one time,the A 2 pulley had the largest PLW(9.56%) and had significant difference compared with the other pulley (P <0.05).While the A 2 A 4′s PLW was the smallest(19.63%) when only one pulley was kept intact,the A 2 A 3 A 4′s PLW was the smallest(9.32%) too when three pulleys left intact.Conclusions:The A 2 pulley′s single effect was the largest in all pulleys,the followings were A 4,A 3,A 1,PA,and A 5.The annular pulley′s effect was larger than that of the cruciform pulleys.