腕关节极度过伸位时韧带长度变化的活体研究  

Changes of ligament lengths at wrist hyperextension in vivo

作　　者：陈靖[1] 谭军[1] 汤锦波[1] 

机构地区：[1]南通大学附属医院手外科,江苏省226001

出　　处：《中华创伤骨科杂志》2012年第4期313-317,共5页Chinese Journal of Orthopaedic Trauma

基　　金：江苏省“135工程”重点学科科研项目（SK2002-21）

摘　　要：目的探讨腕关节在中立位、极度过伸位及过伸桡偏位时腕关节韧带长度的变化情况。方法对6名志愿者腕关节进行CT扫描，获取腕关节在中立位、极度过伸位及过伸桡偏位时的断层扫描图像，利用Mimicsl0．0软件进行三维重建，测量并比较此3种位置下的腕关节掌与背侧共9根韧带的长度。结果与中立位相比，腕关节极度过伸位时桡舟头、桡舟月、长桡月、尺月、尺头、尺三角及背侧骨问韧带止于舟骨部分明显伸长，差异有统计学意义（P〈0．05）；背侧桡腕、背侧骨间韧带止于小多角骨部分明显缩短，差异有统计学意义（P〈0．05）；而从极度过伸位至极度过伸桡偏位时，桡舟头、尺月、长桡月、背侧骨问韧带止于舟骨和三角骨部分明显缩短，差异有统计学意义（P〈0．05）；尺三角、尺头、桡舟月及背侧桡腕韧带明显伸长，差异有统计学意义（P〈0．05）。结论腕过伸位时尺头韧带、尺三角韧带、桡舟月韧带、尺月韧带、桡舟头韧带、长桡月韧带、背侧骨间韧带止于舟骨部分张力较大；而背侧桡腕韧带、背侧骨间韧带止于小三角骨部分张力较小，这些变化规律有助于了锯喻部韧带榀伤的枯堆惩榀伤范嗣．Objective To investigate changes of ligament lengths with the wrist at the neutral and hyperextended positions in vivo. Methods Six volunteers were enrolled in this study. Their wrists were heht in 3 controlled positions： the neutral position of the carpus, hyperexteusion with radial deviation of and hyperextension with radial deviation of We obtained computed tomography scans of the wrists at the 3 positions for each subject for 3-dimensional reconstruction of the carpal and distal radioulnar joint with custmnized software （Mimics 10. 0）. A total of 9 palmar and dorsal wrist ligaments were measured for the length changes. Results Lengths of the radioseaphocapitate （RSC）, long radiolunate （LRL）, radioscapholunate （RSL）, ulnocapitate （UC）, ulnolunate （UL）, ulnotriquetral （UT） ligaments, and the dorsal intercarpal （DIC） inserting on the scaphoid ligament at the position of hyperextension with radial deviation of 0° were significantly longer than those at the neutral position （ P 〈 0. 05） while lengths of the dorsal-radiocarpal （DRC） ligament and the DIC ligament inserting on the trapezoid decreased significantly （ P 〈 0.05）. From 0° to 10°of wrist radial deviation in hyperextension, the UL, RSC, LRL, DIC inserting on the scaphoid and the trapezoid ligaments decreased siguificantly in length （ P 〈 0. 05）, while UT, UC, RSL and DRC ligaments lengthened significantly （ P 〈 0. 05） . Conclusions The RSL, UC and UT ligaments are subjected to higher strains at the position of hyperextension with wrist radial deviation of 10°; the RSC, LRL, UL ligaments and dorsal DIC ligament inserting on the scaphoid are subjected to higher strains at the position of hyperextension; the DRC ligament at the neutral position and the DIC ligament inserting on the trapezoid when the wrist is extended are subjected to less tension. These findings will help understand the mechanism and range of the injury to the wrist ligaments.

关 键 词：腕关节 韧带 体外研究 

分 类 号：R687.3[医药卫生—骨科学]