摘要
目的 测定桡骨远端骨折背屈成角畸形后腕动力肌腱的滑动距离和力臂变化 ,为矫正临床上骨折畸形提供依据。 方法 采用 7只新鲜成人尸体上肢标本 ,将桡侧腕长伸肌腱、桡侧腕短伸肌腱、尺侧腕伸肌腱、桡侧腕屈肌腱和尺侧腕屈肌腱与旋转电压计相连 ,测定肌腱活动距离 ,在桡骨远端、桡骨骨折向背侧成角 10°、2 0°、30°、40°时 ,分别测定在腕屈曲 45°至伸展 45°、桡偏2 0°至尺偏 2 5°过程中 5根腕主要活动肌腱距离 ,用方差分析法分析不同程度桡骨成角时力臂变化的统计学差异。 结果 桡骨骨折背屈成角显著影响腕动力肌腱的力臂 ,骨折畸形程度越大 ,力臂变化越大。背倾成角 10°时即可引起力臂显著变化 ,背倾 30°～ 40°时力臂变化很大。桡侧伸腕肌腱力臂显著增大 ,屈腕肌腱力臂显著减小。 结论 桡骨远端骨折背屈畸形显著影响腕动力学 ,临床上即使 10°的背屈畸形也需要予以矫正 。
Objective To determine the changes in excursions and moment arms of wrist motor tendons in dorsally angulated fractures of the distal radius. Methods Extra articular distal radius fractures were simulated by distal radius osteotomy and angulation of the fracture was produced by applying external fixation in 7 cadeveric hands. Excursions and moment arms of the five principal wrist motor tendons were recorded in the intact wrists when the wrists were passively moved from 45 degrees of wrist flexion to 45 degrees of extension and from 20 degrees of radial deviation to 25 degrees of ulnar deviation. Then the same test was repeated respectively after the fracture was dorsally angulated for 10, 20, 30 and 40 degrees. Results Excursions and moment arms of principal wrist motor tendons were significantly affected by dorsal angulation of distal radius fractures. Amplitude of changes in moment arms increased as the deformities became severe. Statistical analysis revealed that dorsal angulation of 10 degrees or more changed the moment arms greatly. Conclusions Dorsal angulation of distal radius fractures significantly influences wrist kinetics. This study suggests that distal radius fractures should be anatomically reduced. Even 10 degrees dorsally angulation should be corrected.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2001年第10期613-616,共4页
Chinese Journal of Trauma
基金
国家自然科学基金资助项目 (3 9870 82 2 )
教育部高校骨干教师基金资助项目 (2 0 0 0 -65 )
江苏省"青蓝工程"基金
省重点临床专科基金资助项目
