舟骨-大-小多角骨新型融合器的稳定性  

Stability of scaphotrapeziotrapezoid novel arthrodesis apparatus

作　　者：唐亮[1] 卢弘栩 丁健[1] 房宏生 戴永平[1] 洪克建 

机构地区：[1]如皋市人民医院骨科,江苏省如皋市226500

出　　处：《中国组织工程研究与临床康复》2009年第39期7651-7656,共6页Journal of Clinical Rehabilitative Tissue Engineering Research

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

摘　　要：背景:传统的舟骨-大-小多角骨局限性腕关节融合方法包括克氏针、U形钉、AO/ASIF钢板等,术后均需长时间的石膏外固定。而美国设计的新型融合器主要应用于欧美人,并不适合于亚洲人种。目的:模拟舟骨-大-小多角骨局限性腕关节融合,测试课题组根据中国人舟骨-大-小多角骨背侧关节凹陷的解剖形态研发出的新型融合体的稳定性。设计、时间及地点:观察性实验,于2006-04/2007-03在南通大学骨科生物力学实验室完成。材料:40具未经防腐处理的新鲜尸体前臂标本,X射线平片证实无腕关节病变或排列异常。方法:所有标本均模拟舟月骨分离的腕关节不稳定模型,并行新型融合器融合,再模拟屈50°、伸35°、尺偏30°、桡偏10°各50000次极限运动。所有标本均于运动前后行CT扫描、三维重建。主要观察指标:测量桡舟角、桡舟间距、舟骨长度、大-小多角骨宽度及大-小多角骨倾斜角运动前后的变化。结果:运动前桡舟角、桡舟间距、舟骨长度、大-小多角骨宽度及大-小多角骨倾斜角分别为(38.725±2.230)°,(18.988±1.216)mm,(1.686±0.191)cm,(27.360±1.571)mm,(114.975±2.293)°;运动后以上指标分别为:(38.800±2.388)°,(19.215±1.443)mm,(1.683±0.209)cm,(27.718±1.910)mm,(115.300±3.023)°。运动前后相比,所有指标的变化差异均无显著性意义(P>0.05)。结论:应用新型融合器行舟骨-大-小多角骨局限性腕关节融合后,舟骨-大-小多角骨融合体稳定性可靠,腕关节可在背伸35°、掌屈50°、桡偏10°、尺偏30°范围内进行早期功能锻炼。BACKGROUND： Traditional scaphotrapeziotrapezoid limited intercarpal arthrodesis contains Kirschner wire, U-shaped nail, AO/ASIF steel plate and so on. Long-term plaster external fixation was needed following surgery. USA-designed arthrodesis apparatus is mainly suitable for European and people from USA, but not fit for Asian. OBJECTIVE： To simulate scaphotrapeziotrapezoid limited intercarpal arthrodesis, and to test the stability of the novel arthrodesis apparatus developed by the group according to anatomic form of dorsal joint fovea of Chinese scaphotrapeziotrapezoid. DESIGN, TIME AND SETTING： The observational study was performed at the Laboratory of Biomechanics of the Department of Orthopaedics, Nantong University from April 2006 to March 2007. MATERIALS： A total of 40 fresh forearm samples of corpses that were not subjected to antiseptic treatment were used for this study. Radiograph verified that these samples did not develop wrist joint affection or abnormal alinement. METHODS： The cadaver models were imitated limited intercarpal instability before scaphotrapeziotrapezoid arthrodesis used circular plate. Then, simulated flexion 50°, extenion 35°, ulnar deviation 30°, radial deviation 10° ultimate activities （50000）. CT scan and 3-D reconstruction should be taken before and after motion. MAIN OUTCOME MEASURES： The index of the radial-scapho angle （RSA）, radial-scapho distance （RSD）, scapho length （SL）, trapezium-trapezoid inclination （TTI）, trapezium-trapezoid width （TTW） were measured. RESULTS： Prior to motion RSA, RSD, SL, TTW and TTI were （38.725±2.230）°, （18.988±1.216） mm, （1.686±0.191） cm, （27.360±1.571） mm and （114.975±2.293）°. Following motion RSA, RSD, SL, TTW and TTI were （38.800±2.388）°, （19.215±1.443） mm, （1.683±0.209） cm, （27.718±1.910） mm, （115.300±3.023）°. No significant difference in above-described indexes was determined before and after motion （P 〉 0.05）. CONCLUSION： The novel

关 键 词：舟骨-大-小多角骨 局限性腕关节融合 新型融合器 稳定性 

分 类 号：R318[医药卫生—生物医学工程]