四角融合术后腕关节稳定性的衡量指标  

PARAMETERS TO JUDGE THE STABILITY OF WRIST AFTER THE FOUR-CORNER ARTHRODESIS

作　　者：刘涛[1] 刘璠[2] 黄勇[2] 刘坚林[2] 保国峰[2] 朱文峰[2] 

机构地区：[1]镇江市第一人民医院骨科,江苏镇江212000 [2]南通大学附属医院骨科

出　　处：《中国修复重建外科杂志》2006年第7期713-716,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：江苏省"135"工程重点医学人才基金资助项目(RC2003-101)

摘　　要：目的提出衡量腕关节四角融合术后融合体稳定性的指标,探讨术后如何改善腕功能。方法12具新鲜尸体前臂标本,男8具,女4具,左右各6肢,模拟行四角融合术后,固定于腕关节动力学测试仪上,模拟腕关节的掌屈、背伸、尺倾、桡倾等运动,运动前后摄腕关节正、侧位X线片,测量并观察头月角(α)、桡月角(β)、头月正位角(θ)、融合体高度(H)和融合体宽度(W)的变化,并行统计学分析。结果腕关节由运动前中立位至掌屈50°时,α、β、H值与运动前相比,差异均有统计学意义(P<0.01);背伸至40°时,α、β、H值与运动前相比,差异有统计学意义(P<0.01)。腕关节由中立位至桡倾15°时,θ与W与运动前比较,差异有统计学意义(P<0.05);至尺倾25°时,θ与W的运动前比较,差异有统计学意义(P<0.05)。结论头月角、桡月角、头月正位角、融合体高度和融合体宽度等指标可用于衡量四角融合术后融合体的稳定性。Objective To find out some parameters to judge the stability of the wrists after four-corner artbrodesis and to explore the strategy for improving the range of motion （ROM） of the wrist after four-corner artbrodesis. Methods After the simulated four-corner artbrodesis was performed in both wrists of 8 men and 4 women cadaver, the wrists were fixed on the wrist motor simulator; and wrist movement including flexion, extension, radial deviation, ulnar deviation was simulated. The standard posteroanterior and lateral radiographs were taken for measuring the change of capitolunate angle （α）, radiolunate angle （β）, capitolunate posteroanterior angle （θ）, the height （H）and width （W）of the fused four carpal bone bloc. Results There were statistically significant differences in α,β,θ angles （P〈0. 01）in the case of 50° flexion or 40° extension, and in H and W values （P〈0. 05） in the case of 25° ulnar deviation or 15° radial deviation when compared with before movement. Conclusion Capitolunate angle, radiolunate angle, capitolunate posteroanterior angle, the height and the width of the fused four carpal bone bloc can be used to judge the stability of the wrists after four-corner artbrodesis.

关 键 词：四角融合术 舟月骨进行性塌陷 稳定性 局部解剖 

分 类 号：R687.4[医药卫生—骨科学]