治疗桡尺远侧关节慢性疾患手术的生物力学研究

Biomechanical Study of the Operative Procedures in the Treatment of Chronicderangement of the Distal Radioulnar Joint

目的 :对尺骨头切除术及Sauve′ Kapandji手术后尺骨传递载荷的变化进行生物力学比较分析。方法 :采用8侧青年新鲜尸体上肢标本 ,用MTS试验机控制加载 ,压敏感片方法测压力。计算出 2种手术后尺侧腕传递载荷的变化值。结果 :尺骨头切除术后传递至尺骨的载荷量显著减小 (P <0 .0 1) ;Sauve′ Kapandji手术后 ,尺骨传递轴向载荷的量接近正常标本水平。结论 :尺骨头切除后影响桡尺远侧关节的稳定性 ,使尺骨载荷量显著性降低 。

Objective: To compare the effect of Darrach procedure and Sauve′ Kapandji procedure on axial load transmission across the wrist joint. Methods: 8 upper extremities were taken from fresh young adult cadavers. During these experiments, 100N axial load controlled by MTS universal testing machine was applied across the wrist joint at each position, and the force through ulna was measured by means of pressure sensitive film and the calculation of the computer. The changing value of ulna load transmission was calculated. Results: After complete resection of the distal end of the ulna, ulna load transmission dropped dramatically in all of the tested wrist and forearm positions ( P <0.01). After Sauve′ Kapandji procedures, ulna load transmission dropped close to the level of the normal specimens. Conclusions: Darrach procedure resulted in DRUJ unstable and ulnar load transmission dropped dramatically, and could not accord with biomechanical requirement.