摘要
目的:明确掌、背侧深层桡尺韧带对桡尺远侧关节的稳定作用。方法:将14具新鲜冰冻上肢标本随机分为2组,解剖显露桡尺远侧韧带,分别标记掌、背侧深层韧带,解剖游离出旋前圆肌及旋后肌,在桡骨Lister结节处垂直骨面置一枚克氏针,前臂中立位时在尺骨远端同一水平位置平行置一枚克氏针作为标记点,用自制的夹具将标本固定于生物力学仪器上,使肘关节屈曲90°,固定尺骨,使桡骨可围绕尺骨自由旋转。于旋前圆肌加载50 N的力模拟前臂主动旋前,于旋后肌加载60 N的力模拟主动旋后,分别切断掌、背侧深层桡尺韧带,测量桡骨相对于尺骨的位移。结果:切断掌侧深层韧带后,前臂旋前时桡骨相对于尺骨的位移明显改变(t=5.591,P=0.001),旋后时无明显改变(t=0.433,P=0.680)。切断背侧深层韧带后,前臂旋前时桡骨相对于尺骨的位移无明显改变(t=1.000,P=0.356),旋后时明显改变(t=-6.225,P=0.001)。结论:单独切断掌侧深层桡尺韧带会造成桡尺远侧关节旋前时不稳定,单独切断背侧深层桡尺韧带会造成桡尺远侧关节旋后时不稳定。
Objective: To evaluate the role of the deep radioulnar ligament in the stability of the distal radioulnar joint( DRUJ). Methods: In the study,14 fresh cadaver upper extremities were randomly divided into two groups. After exposuring the palmar and dorsal deep distal radioulnar ligament,one group was marked as palmar deep radioulnar ligament,and the other group was marked as dorsal deep radioulnar ligament. The pronator teres and the supinator were exposed. A Kirschner wire perpendicular to the bone on Lister tubercle of radius was inserted,then another Kirschner wire on the same level of ulnar inserted when the forearm was in neural position,which was kept parallel to the first Kirschner wire. These specimens were mounted on a specially designed jig which held the limb rigidly,keeping the elbow flexion and the ulnar fixation. The radius could freely rotate around the ulnar. Then 50 N force on the pronator teres was applied to simulate the active pronation,and 60 N force on the supinator to simulate the active supination. The active pronation was stimulated,and the displacement of the distal radius was measured with respect to the ulna. The active supination was atimulated,and the displacement of the distal radius was measured with respect to the ulna. The palmar deep radioulnar ligament in one group was cut,then the displacement of the distal radius measured with respect to the ulna when the forearm was in pronation and supination. The dorsal deep radioulnar ligament in the other group was cut,and the displacement of the distal radius measured with respect to the ulna when the forearm was in pronation and supination. Results: After resection of the palmar deep radioulnar ligament,the displacement of the distal radius with respect to the ulna was statistically significantly different when the forearm was in pronation( t = 5. 591,P = 0. 001),but there was no difference when the forearm was in supination( t = 0. 433,P = 0. 680). After resection of the dorsal deep radioulnar ligament,the displacement of the distal ra
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2017年第3期518-521,共4页
Journal of Peking University:Health Sciences
关键词
腕关节
生物力学
关节不稳定性
韧带
关节
Wrist joint
Biomechanics
Joint instability
Ligaments,articular
