摘要
目的通过测量肘关节内侧副韧带(medial collateral ligament,MCL)完整状态、肘关节恐怖三联征模型中损伤状态及重建后肘关节的生物力学指标,探讨MCL对肘关节稳定性的影响,评价修复MCL的疗效。方法选用6具新鲜冰冻男性成人肘关节标本制成肘关节恐怖三联征模型。采用数字散斑相关法,分别在1.5 N·m的外翻及内旋力矩下,在肘关节0°、30°、60°、90°屈曲时测量:(1)肘关节完整状态(对照组)下肱尺关节的外翻及内旋角度;(2)恐怖三联征模型下,固定冠突、桡骨头,修复外侧副韧带,不修复MCL(修复组1)时肱尺关节的外翻及内旋角度;(3)恐怖三联征模型下,固定冠突、桡骨头,修复外侧副韧带,修复MCL(修复组2)时肱尺关节的外翻及内旋角度。实验数据采用SPSS 17.0统计软件进行分析。结果对照组0°、30°、60°、90°屈曲角度下的外翻角度为(3.3±0.7)°、(3.4±1.3)°、(3.6±0.9)°、(3.7±1.5)°;修复组1的外翻角度为(4.7±1.7)°、(5.0±1.9)°、(6.1±2.0)°、(6.9±2.2)°;修复组2的外翻角度为(3.9±0.9)°、(4.1±0.8)°、(4.2±1.2)°、(4.4±1.6)°、(4.2±1.2)°。对照组0°、30°、60°、90°屈曲角度下的内旋角度为(6.0±2.0)°、(5.8±1.8)°、(6.2±1.2)°、(8.3±1.1)°;修复组1的内旋角度为(6.5±1.9)°、(7.1±2.2)°、(8.2±1.8)°、(12.3±2.1)°;修复组2的内旋角度为(6.2±1.2)°、(6.0±1.6)°、(6.5±1.3)°、(8.4±1.5)°。肘关节恐怖三联征损伤中MCL修复后(修复组2)与MCL修复前(修复组1)比较,肘关节外翻及内旋稳定性明显增大,差异有统计学意义(P<0.05),MCL修复后(修复组2)与完整状态下的肘关节(对照组)比较,外翻及内旋稳定性组间差异无统计学意义(P>0.05)。结论恐怖三联征中MCL损伤后会导致肘关节外翻及内旋不稳定,临床上对肘关节恐怖三联征患者修复MCL可能会改善肘关节的稳定性。
Objective To investigate the effects of medial collateral ligament（ MCL） on the stability of the elbow and to evaluate the results after the reconstruction of MCL by measuring the biomechanical indexes of the elbow with or without terrible triad injuries before and after the reconstruction. Methods The elbow specimens from 6 freshfrozen male adults were adopted to establish an elbow model with terrible triad injuries. The digital speckle correlation method（ DSCM） was used. The following angles were measured when the valgus and internal rotation moments were 1.5 N·m and the elbow flexion angles were 0°, 30°, 60° and 90° respectively.（ 1） The valgus and internal rotation angles of the ulnohumeral joint of the normal elbow were measured（ control group）.（ 2） In the elbow model with terrible triad injuries, the valgus and internal rotation angles of the ulnohumeral joint were measured with the coronoid process and radial head fixed and lateral collateral ligament（ LCL） but not MCL repaired（ repair group 1）.（ 3） In the elbow model with terrible triad injuries, the valgus and internal rotation angles of the ulnohumeral joint were measured with the coronoid process and radial head fixed and LCL and MCL repaired（ repair group 2）. All the experimental data were statistically analyzed by using SPSS 17.0 software. Results The valgus angles were（ 3.3±0.7） °,（ 3.4±1.3） °,（ 3.6±0.9） ° and（ 3.7±1.5） ° in the control group when the elbow flexion angles were 0°, 30°, 60° and 90° respectively, which were（ 4.7±1.7） °,（ 5.0±1.9） °,（ 6.1±2.0） ° and（ 6.9±2.2） ° in the repair group 1 and（ 3.9±0.9） °,（ 4.1±0.8） °,（ 4.2±1.2） ° and（ 4.4±1.6） ° in the repair group 2. The internal rotation angles were（ 6.0±2.0） °,（ 5.8±1.8） °,（ 6.2±1.2） ° and（ 8.3±1.1） ° in the control group when the elbow flexion angles were 0°, 30°, 60° and 90° respectively, which were（ 6.5±1.9） °,（ 7.1±2.2） °,（ 8.2�
出处
《中国骨与关节杂志》
CAS
2015年第10期785-789,共5页
Chinese Journal of Bone and Joint
关键词
肘关节
侧副韧带
创伤和损伤
修复外科手术
生物力学
恐怖三联征
Elbow joint
Collateral ligaments
Wounds and injuries
Reconstructive surgical procedures
Biomechanics
Terrible triad
