创伤性桡骨头脱位的生物力学探讨

Biomechanics Analysis of Isolated Traumatic Dislocation of the Radial Head

孤立的创伤性桡骨头脱位系肘部的复杂性损伤,多为跌伤时手固定于地面,身体围绕上肢旋转所致。但对其损伤的生物力学原理尚未系统研究。作者报告8年间收治的7例创伤性桡骨头脱位,其中肘伸直位跌伤4例,扭胳膊伤2例,拳击伤1例。作者复习了有关的解剖特征,并运用生物力学理论分别对肘伸直位跌倒、扭胳膊和拳击引起的单纯桡骨头脱位的机制进行了探讨。指出前臂被动过度旋前产生的剪应力,是引起桡骨头脱位的主要原因。

Isolated traumatic dislocation of the radial head is a complicated injury at the elbow. As the affected arm fixed on the ground and the patient's body pivots around this extremity, the radial head could usually be dislocated. At present, the biomechanics theory of this injury are not-completely understood yet. Seven patients of isolated traumatic dislocation of the radial head were reported between 1982 to 1990, of which, four fell heavily at the arm straight, two were strained by pronation of the forearm, one was caused by boxing. According to the clinical materials and relevant anatomy and biomechanics theory, the mechanisms of above-mentioned dislocation were discussed respectively. Suggesting that tangential stress produced by excessive passive pronation of forearm was major factor of isolated tramatic dislocation of the radial head. This study may provide a scientific basis for the closed reduction of the radial head.