前臂旋转和腕关节过伸时舟月骨间韧带长度变化及其意义  

Length changes and their significance of scapholunate interosseous ligament at forearm rotation and wrist hyperextension

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,手外科研究所,江苏省手外科临床医学中心,226001

出　　处：《中华创伤杂志》2015年第3期236-240,共5页Chinese Journal of Trauma

基　　金：江苏省重点学科科研课题资助项目（XK2011-31）

摘　　要：目的 探讨前臂旋转和腕关节过伸时舟月骨间韧带（SLIL）的长度变化及其意义.方法 将18例志愿者（男12例,女6例,年龄20～38岁,平均28岁;既往无全身性疾病或上肢外伤史,经X线片检查腕部无先天性疾病、退变或其他骨性病变）按随机数字表法分为前臂旋转组（6例）、腕关节过伸组（6例）和腕关节过伸旋转组（6例）,对其右腕关节进行CT扫描,获取腕关节断层扫描图像,并进行三维重建,对中立位、极度过伸位及过伸桡偏位SLIL的长度进行比较分析.结果 与中立位比较,腕关节极度过伸位时,SLIL掌侧区域远侧、中间、近侧部分韧带长度分别增加（1.4 ±0.5）mm、（1.4±0.4）mm、（1.3±0.4）mm;前臂最大旋前位时,SLIL掌侧区域远侧、中间、近侧部分韧带长度分别增加（0.3 ±0.1）mm、（0.2 ±0.1）mm、（0.3±0.1）mm;腕关节极度过伸位、过伸桡偏位以及过伸旋转位时,SLIL掌侧区域和部分近侧区域明显伸长（P＜0.05）;前臂最大旋前位时,SLIL掌侧区域和部分近侧区域伸长（P＜0.05）.结论 SLIL掌侧区域和近侧区域在腕关节过伸时明显伸长,在前臂最大旋前位轻度伸长,表明这部分韧带在腕关节过伸时张力较大,提示腕关节过伸位和前臂旋前时可能更容易损伤SLIL.Objective To investigate the length changes of scapholunate interossous ligament （SLIL） at wrist full extension and forearm rotation and the related significance.Methods Eighteen healthy volunteers （12 males and 6 females） aged at 20-38 years （mean,28 years） were divided into forearm rotation group,wrist hyperextension group and wrist hyperextension-rotation group according to the random number table,with 6 cases per group.CT images of the wrist were analyzed and reconstructed in three-dimensions.Length of SLIL in dorsal,proximal and palmar segments was measured in different settings and compared.Results Conpared with the neutral position,lengths of palmar SLIL in distal,middle and proximal parts increased by （1.4 ±0.5）mm,（1.4 ±0.4）mm and （1.3 ±0.4）mm respectively in wrist hyperextension and increased by （0.3 ± 0.1） mm,（0.2 ± 0.1）mm and （0.3 ± 0.1）mm respectively in forearm maximal pronation.At the positions of wrist full extension,hyperextension with radial deviation or forearm maximal rotation,the palmar and part of proximal SLIL were elongated significantly （P 〈 0.05）.At forearm maximal pronation,palmar and part of proximal SLIL were elongated （P 〈 0.05）.Conclusions At wrist full extension,strain is greater in the palmar and proximal components of the SLIL.SLIL is inclined to injury at wrist hyperextension and forearm rotation.

关 键 词：腕关节 韧带 舟月骨 

分 类 号：R687.3[医药卫生—骨科学]