摘要
目的 测定 5种治疗腕塌陷术式术后腕关节的生物力学变化。方法 成人新鲜腕关节标本 6侧 ,模拟不同的治疗腕塌陷的术式。于腕关节内置入压敏片 ,在双轴液压材料测试系统 (materialtestsystemMTS ,858型 ,美国产 )上 ,于腕关节在中立位、掌屈 5°位、背伸 3 0°位、桡偏 10°位、尺偏 15°位下加载 ,分析压敏片上的相关信息。结果 腕中立位下 ,正常的腕单位平均面积的负荷为 [(2 2 .9± 4.3 )N/cm2 , x±s,下同 ]。腕舟骨远端切除 +近端和头月融合术、腕舟骨全切除 +头月融合术两手术后 ,该值无明显变化。四角融合术后 ,负荷值为 (2 9.4± 8.5)N/cm2 。腕舟骨 +三角骨切除和头月融合术后为 (10 3 .2± 3 7.2 )N/cm2 ,近排腕骨切除术后为 (13 6.4± 3 0 .7)N/cm2 。各功能位状态下 ,近排腕骨切除术以腕中立位时的负荷最高 ;而另 4种部分腕骨融合术都以腕背伸 3 0°位的单位面积负荷最高。结论 在正常腕中立位下 ,通过腕关节的压应力负荷十分均匀。在腕舟骨远断切除 +近端和头月融合术、腕舟骨全切除 +头月融合两术后 ,生物力学改变不明显。四角融合术后 ,腕关节的单位面积负荷开始上升 ,腕舟骨 +三角骨切除和头月融合术、近排腕骨切除术后该负荷开始大幅度上升。近排腕骨切除术后形成的桡头关节及其生?
ObjectiveTo investigate the biomechanical changes after differ ent operations for treatment of carpal collapse. MethodsSix fr esh adult cadaver wrists were used. Five types of surgical procedures for carpal collapse were sim ulated on the specimens. Pressure sensitive films were inserted into the wrists and loaded on the material testing system. The same testing procedure were repea ted under every functional motion (neutral position, 5°palmar flexion, 30°dors al extension, 10°radial deviation, 15°ulnar deviation). Data collected from th e films were studied. ResultsUnder neutral position, the avera ge wrist pressur e intensity was 22.9±4.3 N/cm 2. There were no statistically significant chang es of this value after excision of the distal segment of the scaphoid and arthrode sis of the proximal segment, the capitate and the lunate, and after scaphoid exc ision and capitolunate arthrodesis. The average pressure intensity after four-c o rner arthrodesis reached 29.4±8.5N/cm 2, and the value after capitolunate fusi on with scaphoid and triquetrum excision and that of proximal row carpectomy were 103.2±37.2N/cm 2 and 136.4±30.7N/cm 2 respectively. Under the different wris t po sitions within the functional range, the 30°dorsal extension position of all li mited wrist arthrodesis had the highest pressure intensity. In proximal row carp ectomy, the highest pressure intensity was found in neutral position. Co nclusionUnder neutral position, the pressure distribution of normal wr ists was extreme ly even. There were no obvious biomechanical changes after excision of the dista l segment of scaphoid with arthrodesis of proximal segment of the scaphoid, the capitate and the lunate and after scaphoid excision with capitolunate arthrodesi s. The general wrist pressure intensity of four-corner arthrodesis was higher. T he highest general wrist pressure intensity was found in the groups of proximal row carpectomy and capitolunate arthrodesis with scaphoid and triquetrum excisio n. The radiocapitate joint formed after proximal row carpectomy boasted the obvi ously abnormal biomechanics.
出处
《中华手外科杂志》
CSCD
2004年第1期8-10,共3页
Chinese Journal of Hand Surgery
基金
成都军区医药卫生科研基金资助项目 ( 0 1A0 1 6 )
