正常腕关节运动时腕中关节运动学在体研究  

A vivo study of kinematic relations of wrist joint to intercapal joints

作　　者：樊志强[1] 徐永清[1] 李晶[1] 刘力[1] 朱跃良[1] 陈斌[1] 姜楠[1] 丁薇[1] 

机构地区：[1]成都军区昆明总医院全军骨科中心,昆明医学院教学医院,昆明650032

出　　处：《中国临床解剖学杂志》2009年第1期5-8,共4页Chinese Journal of Clinical Anatomy

基　　金：成都军区十一五重点项目(Z07003)

摘　　要：目的:确定腕关节在屈伸、桡尺偏运动时腕中关节的运动学。方法:选健康志愿者10名,腕关节CT扫描后,在自行开发的外科手术模拟系统内三维重建,计算出舟骨、月骨的质心、转动惯量轴,在头状骨上人为建立参照坐标系,用有限螺旋轴表达舟月骨相对于头状骨的旋转及平移运动。结果:腕关节尺偏40°时,舟骨绕头状骨背伸(19.2±10.3)°,桡偏(19.3±6.2)°,月骨背伸(27.8±11.6)°,桡偏(14.0±4.8)°;腕关节桡偏20°时,舟骨绕头状骨掌屈(12.2±5.4)°,尺偏(15.0±3.8)°,月骨掌屈(9.9±3.9)°,尺偏(15.3±3.9)°;腕关节掌屈60°时,舟骨绕头状骨背伸(32.6±5.2)°,月骨背伸(41.5±6.9)°;腕关节背伸60°时,舟骨绕头状骨掌屈(7.9±3.9)°,月骨掌屈(20.7±5.0)°。结论:腕关节桡-尺偏,舟、月骨相对于头状骨除了尺-桡偏外,还有较大的非平面运动。当腕关节屈-伸运动,舟骨、月骨相对于头状骨的相对运动主要为伸-曲运动,非平面旋转运动较小。舟骨相对头状骨的运动小于月骨,即舟骨跟随远侧列腕骨一起运动,但又不同于远侧列腕骨之间的微动,舟骨起着远近侧列腕骨的桥梁作用。Objective： To decide the kinematics of the intercarpal joints as the wrist joint moving. Methods： Wrist joints of 10 healthy volunteers were CT scanned, and three-dimensionally reconstructed by surgery operation simulation system developed by Dr lijing. The centroids and inertial rotatory axises of scaphoid and lunatum were calculated out by this system, and coordinates were founded in the capitatum to express the rotation and translation of the scaphoid and lunatum relative to the capitatum with finite screw axises. Results： When the ulnar deviantion of the wrist joint was 40°, the scaphoid extention would be （19.2± 10.3）° relative to capitate, the radial deviation （19.3±6.2）°, the lunar extention （27.8±11.6）°, and the radial deviation （14.0±4.8） °; when the radial deviation of the wrist joint was 20°, the scaphoid flection （ 12.2 ±6.4）°, the ulnar deviation （15.0±3.8）°, the lunare flection （9.9±3.9）°, and the ulnar deviation （15.3±3.9）°; when the wrist joint flection was 60°, the scaphoid extention （32.6±5.2）°, and the lunar extention （41.5±6.9）°; when the wrist joint extention was 60°, the scaphoid flection （7.9±3.9）°. Conclusions： While the wrist joint is processing radial-ulnar deviation, there appears out-of-plane motion of the scaphoid and lunatum besides the radial-ulnar deviation; while flexing and extending, in addition to some slight out-of-plane motion, the main motion of the scaphoid and lunate are extension and flexion, and the lunate moves more than the scaphoid. The scaphoid acting as the bridge between distal and proximal row of carpal bones follows the distal row of carpal bones, which differs from the slight movements of the distal row of carpal bones.

关 键 词：腕关节 腕骨 在体 运动学 

分 类 号：R322.72[医药卫生—人体解剖和组织胚胎学] R323.71[医药卫生—基础医学]