腕关节极限运动与头-月-三角-钩骨融合体稳定性的关系  

Impact of maximal movement on initial stability of the four-corner arthrodesis

作　　者：刘璠[1] 唐亮[1] 刘涛[1] 

机构地区：[1]南通大学附属医院骨科,226001

出　　处：《中华创伤骨科杂志》2006年第12期1153-1156,共4页Chinese Journal of Orthopaedic Trauma

基　　金：江苏省"135"工程重点医学人才基金资助(RC2003-101)

摘　　要：目的探讨腕关节极限运动与头-月-三角-钩骨四角融合体稳定性的关系。方法21具未经防腐处理的新鲜尸体肘关节以远标本,左11具,右10具。模拟屈、伸、尺偏及桡偏运动,每个方向分别施以极限运动。每次运动前后均摄标准前后位及侧位片,测量前后位片融合体高度、融合体宽度、头月正位角及侧位片桡月角、头月角,并观察克氏针松动及弯曲情况。所有腕关节均采用运动前后自身对照。结果当腕关节屈曲至35°、背伸至25°、桡偏至10°、尺偏至15°时,极限运动对融合体的稳定性无影响,未出现融合体的解体。而当屈曲至40°、背伸至30°时,头月角、桡月角及融合体高度与对照组相比差异均有统计学意义(P＜0．05)；当桡偏至15°、尺偏至20°时,融合体的稳定性受到影响,头月正位角、融合体宽度与对照组相比差异均有统计学意义(P＜0．01)。结论极限运动时。在掌屈40°、背伸30°、桡偏15°、尺偏20°的范围内进行功能锻炼,不会影响四角融合体的稳定性,但应避免环转运动。Objective To explore the impact of maximal movement on the stabilization of the four corner arthrodesis. Methods Flexion, extension, ulnar deviation and radial deviation movements were simulated on the wrists of 21 fresh cadaver fore-arm specimens. Maximal movements were performed in each of the four directions. Firstly, anteroposterior view and lateral view photos were taken before and after movement in each direction. Secondly, capito-lunate angle, radio-lunate angle, captio-lunate posteroanterior angle, the height and width of the syzygium were measured before and after movement in each direction. The wrist before each kind of movement was used as the control for itself after the movement in the test. Results Compared with the control data, the differences in capito-lunate angle, radio-lunate angle and the height of the syzygium were statistical significant before and after movement in the direction of flexion 40° and extension 30° （ P 〈 0.05 ） . Moreover, the differences in the captio-lunate posteroanterior angle and the width of the syzygium were also statistical significant before and after movement in radial deviation 15° and ulnar deviation 20° （ P 〈 0.01 ） . Maximal movements at other positions had little impact on the stability of the arthrodesis. Conclusion It is safe to perform high intensity movements to the four-corner syzygium when the range of motion is not beyond flexion 40°, extension 30°, ulnar deviation 20° and radial deviation 15°. Cireumduetion should be avoided.

关 键 词：极限运动 四角融合 稳定性 

分 类 号：R687.4[医药卫生—骨科学]