腕中关节的在体MRI三维运动学特征  

In vivo MRI three-dimensional kinematics of midcarpal joint

作　　者：杨勇[1] 陈山林[1] 田文[1] 李忠哲[1] 邓玖征[1] 白荣杰[2] 钱占华[2] 田光磊[1] 

机构地区：[1]北京积水潭医院手外科,100035 [2]北京积水潭医院放射科,100035

出　　处：《中华骨科杂志》2015年第12期1228-1234,共7页Chinese Journal of Orthopaedics

基　　金：国家临床重点专科建设项目一手外科基金[财社（2010）305号];国家自然科学基金（81371515）

摘　　要：目的通过MRI技术探讨腕中关节在不同运动模式下的在体运动特点和规律。方法健康志愿者12名，行右腕投掷平面（桡背伸25°、50°，掌尺屈10°、20°）、屈伸平面（屈曲0°、25°、50°、75°，背伸20°、40°、60°）和桡尺偏平面（桡偏10°、20°，尺偏20°、40°）运动模式下共15个体位的MR检查。应用自行研发的腕关节运动学测量软件分析头状骨分别相对舟骨、月骨和三角骨的运动规律。结果在投掷平面运动中，当腕关节从背伸桡偏位向掌屈尺偏位运动时头状骨相对舟骨、月骨、三角骨分别旋前20°、20°、28°，掌屈2°、25°、17°，尺偏58°、59°、66°；头状骨相对舟骨的掌屈幅度小于月骨和三角骨，相对桡骨旋前9°、尺偏56°；舟骨、月骨、三角骨相对桡骨分别旋后11°、11°、19°，桡偏3°、3°、1100在屈伸平面运动中，当腕关节从背伸位向掌屈位运动时，头状骨相对舟骨、月骨、三角骨分别旋前47°、45°、47°，掌屈-11°、37°、22°，尺偏89°、103°、107°；头状骨相对舟骨背伸、相对月骨和三角骨掌屈，相对桡骨旋前38°、尺偏82°；舟骨、月骨、三角骨相对桡骨旋后9°、7°、9°，桡偏7°、22°、25°。在桡尺偏平面运动中，当腕关节从桡偏向尺偏运动时，头状骨相对舟骨、月骨、三角骨分别旋后13°、6°、2°，背伸-9°、6°、2°，尺偏6°、0°、7°，头状骨相对舟骨掌屈、相对月骨和三角骨背伸。结论腕中关节的运动是在空间中的三维复合运动，以冠状面的运动最为显著，其次为横断面。舟骨是腕中关节运动的关键，在矢状面上舟骨与头状骨同步运动，在横断面和冠状面上舟骨与月骨和三角骨协同运动。Objective To analyze the in vivo three-dimensional kinematics of the midcarpal joint and figure out the char- acteristics and regularity of the midcarpal joint in different movement patterns. Methods We studied the in vivo three-dimen- sional kinematics of the midcarpal joint with a markerless bone registration technique. Magnetic resonance images of twelve heahhy volunteers＂ wrist were acquired during motion patterns of dart throwing motion （DTM）, extension-flexion motion （EFM）, and radioulnar deviation （RUD）. A total of fifteen wrist positions were performed on each volunteer. Image data were input to the software of carpal kinematics measurement platform. Motions of the capitate relative to the seaphoid, lunate and triquetrum in cross- sectional, sagittal and coronal planes were analyzed. Results In DTM pattern, during the wrist rotated from radial extension to ul- nar flexion, motions of the eapitate relative to the seaphoid, lunate and triquetrum were respectively pronation 20°, 20°, 28° flexion 2°, 25°, 17° and ulnar deviation 58°, 59°, 66°. In EFM, when the wrist rotated from extension to flexion, motions of the capitate rel- ative to the scaphoid, lunate, and triquetrum were pronation 47°, 45°, 47°, flexion -11°, 37°, 22°, ulnar deviation 89°, 103°, 107° respectively. In RUD, when the wrist rotated from radial deviation to ulnar deviation, motions of the capitate relative to the scaph- oid, lunate and triquetrum were supination 13°, 6°, 2°, extension -9°, 6°, 2°, ulnar deviation 6°, 0°, 7° respectively. During DTM and EFM, capitate and proximal carpal row rotated reversely in cross-sectional and coronal plane. In DTM, relative to the scaphoid, the capitate pronated by 9° and ulnar deviated by 56°, while the scaphoid, lunate and triquetrum supinated by 11°, 11°, 19° and radial deviated by 3°, 3°, 11° respectively. In EFM, relative to the scaphoid, the capitate pronated by 38°and ulnar deviated by 82°, while the scaphoid, lunate and triquetrum supinated by

关 键 词：腕关节 磁共振成像 成像 三维 生物力学 

分 类 号：R687.3[医药卫生—骨科学]