腕投掷运动时腕关节韧带长度变化的活体研究  

Changes in carpal ligament length in throwing motion of the wrist

作　　者：顾晓坤[1] 徐静[1] 汤锦波[1] 顾剑辉[1] 

机构地区：[1]南通大学附属医院手外科、手外科研究所、江苏省手外科临床医学中心,226001

出　　处：《中华创伤骨科杂志》2010年第7期664-667,共4页Chinese Journal of Orthopaedic Trauma

基　　金：江苏省“135工程”重点学科科研课题基金（SK2002-21）;教育部优秀青年教师基金;江苏省手外科临床医学中心建设基金

摘　　要：目的 探讨腕关节在投掷运动过程中腕关节韧带长度的变化.方法 对6例志愿者腕关节进行CT扫描,获取腕关节在投掷运动过程中的5个位置,即桡偏20°背伸60°,桡偏10°背伸30°,中立位,尺偏20°掌屈30°,尺偏40°掌屈60°时各腕骨、尺桡骨远段的三维重建图像,在重建图像基础上利用Mimics软件测得在腕关节投掷运动过程中掌、背侧腕关节韧带的长度.结果 腕关节由中立位至桡偏20°背伸60°时桡舟头韧带、长桡月韧带、尺头韧带、尺三角韧带长度显著伸长,分别延长（3.4±0.5）、（2.0±0.2）、（2.6±0.5）、（2.1±0.4）mm,差异均有统计学意义（P〈0.05）;腕关节由中立位至尺偏400掌屈60°时背侧桡腕韧带、背侧骨间韧带止于小多角骨部分长度显著伸长,分别延长（1.7 ±0.2）、（3.8 ±0.4）mm,差异有统计学意义（P〈0.05）.尺月韧带、背侧骨问韧带止于舟骨部分在投掷运动过程中其长度均较中立位时旱增长趋势.结论 腕关节在桡背伸至尺掌屈运动过程中,桡舟头韧带、长桡月韧带、尺头韧带、尺三角韧带缩短,提示张力减低,背侧桡腕韧带、背侧骨间韧带止于小多角骨部分伸长,张力增大,尺月韧带、背侧骨间韧带止于舟骨部分于中立位时张力最小,其变化规律有助于指导临床腕关节韧带损伤的修复.Objective To investigate changes in wrist ligament length when the wrist is in different throwing positions.Methods Six wrists of 6 volunteers were enrolled in the experiment to obtain CT scans at 5 throwing positions of the wrist：20 degrees of radial deviation with 60 degrees of extension,10 degrees of radial deviation with 30 degrees of extension,neutral,20 degrees of ulnar deviation with 30 degrees of flexion,and 40 degrees of ulnar deviation with 60 degree of flexion.The carpal and distal radioulnar joint structures were reconstructed 3-dimensionally with customized software.Changes in length of the palmar and dorsal wrist ligaments in throwing motion were computed with the software. Results From wrist radial deviation with extension to ulnar deviation with flexion,the lengths of the radioscaphocapitate（RSC）ligament.the long radiolunate ligament（LRL）,the ulnoceapitate ligament（UC）and the ulnotriquetral ligament （UT）decreased significantly（P〈0.05）,but the lengths of dorsal radiocarpal ligament（DRC）and the dorsal interearpal ligament（DIC）inserting on the trapezoid increased significantly（P〈0.05）.The lengths of ulnolunate ligament（UL）and the dorsal interearpal ligament inserting on the seaphoid were the shortest when the wrist was in the neutral position. Conclusions At wrist ulnar deviation with flexion,the RSC,LRL.UC and UT ligaments are slack.At wrist radial deviation with extension.the DRC ligament and the dorsal intercaroal ligament inserrting on the trapezoid are slack.The UL ligament and the dorsal intercarpal ligament inserting on the seaphoid are the slackest in the neutral position.These positions may be favorable to the healing of these ligaments.

关 键 词：腕关节 韧带 运动 活体研究 

分 类 号：R686[医药卫生—骨科学]