肱桡关节在肘关节内侧副韧带损伤后的生物力学变化  

The biomechanical changes of humeroradial joint after elbow joint medial collateral ligament injured

作　　者：张培楠[1] 武娜[2] 张鑫[1] 贾永利[1] 杨新明[1] 马朋朋[1] 

机构地区：[1]河北北方学院附属第一医院骨科,河北张家口075000 [2]河北北方学院附属第一医院小儿外科,河北张家口075000

出　　处：《河北医科大学学报》2017年第5期542-547,共6页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(20150056)

摘　　要：目的通过测量肘关节内侧副韧带(medial collateral-ligament,MCL)前束在不同状态下(完整、部分断裂、完全断裂)肱桡关节的生物力学指标,探讨MCL前束在不同状态下对肱桡关节的生物力学影响。方法应用人体肘关节标本,将压敏胶片(pressure sensitive film)置入肱桡关节间隙,测量MCL前束在不同状态下(完整、部分断裂、完全断裂)及肘关节在不同屈曲角度下肱桡关节内的生物力学指标,即压强和关节接触面积;根据MCL前束的不同状态将标本分为前束完整组(1组)、前束部分断裂组(2组)及前束完全断裂组(3组),每组20个标本,将得出的数据进行统计学分析。结果组内比较,各组在30°、60°时的压强均高于0°,到90°时略有降低,但仍高于0°,其差异有统计学意义(P<0.05);组间比较,30°、60°时3组的压强高于1组和2组,差异有统计学意义(P<0.05),0°、90°时3组间差异无统计学意义(P>0.05)。组内比较,1组、2组和3组在30°、60°、90°时接触面积均少于0°,差异有统计学意义(P<0.05);组间比较,在30°、60°时3组的接触面积少于1组和2组,差异有统计学意义(P<0.05),在0°、90°时3组间差异无统计学意义(P>0.05)。结论 MCL前束在肘关节外翻稳定当中意义重要,损伤或断裂后可造成肘关节不稳定,造成肱桡关节内压强增大、关节接触面积减小。肘关节在伸直位时,肘关节处于相对稳定状态,比屈曲位时可承受更大的外翻应力。Objective To approach the biomechanical effect of anterior funicle of medial collateral-ligament（MCL） on differeht state for the humeroradial joint by taking measurement of the vitodynamics index of humeroradial joint in different state （complete 、 partly brake、 brake） of the MCL. Methods Used the human elbow joint specimen and put the pressure sensitive film into the space of humeroradial joint,then take measurement of the pressure and the contact area of humeroradial joint in the different state and the anterior funicle of MCL and in the different flex angle. Take the separation of the specimen into 3 groups according to the different state of the anterior funicle of MCL. the anterior funicle of MCL complete group（group 1）, the anterior funicle of MCL injured（partly brake） group（group 2） and the anterior funicle of MCL brake group（group 3）. There were 20 cases in every group. Get the data and make the statistics analysis. Results Compared intra group, the pressure of each group at 30 ° and 60 ° is higherthan that at 0 °, at 90 ° that decreased slightly, but still higher than 0 °, the difference had statistically significant（P〈0.05）. Compared between groups, the pressure of group 3 is higher than that of group 1 and group 2 at 30 ° and 60 °（P〈0.05） but had no statistical significance at 0° and 90°（P〈0.05）. Compared intra group, the contact area in every group at 30°, 60°~ and 90° were less than that at 0 °, the difference had statistically significant（P〈0. 05）. Compared between groups, the contact area in group 2 and group 3 were less than that in group 1 at 30° and 60°（P〈0.05） but had no statistically significant at 0° and 90°（P〉0. 05）. Conclusion The anterior funicle of MCL had important significance in the ecstrophy stabilization of the elbow joint, and injured or break could cause the instability of inter-elbow joint and make increasing of the pressure and decreasing of the contact area in humeroradial joint. While the elbow joi

关 键 词：肘关节 侧副韧带 运动损伤 生物力学 

分 类 号：R323.71[医药卫生—人体解剖和组织胚胎学]