近节指骨滑车损伤对近指间关节侧方稳定性影响的应用解剖学研究  

Applied anatomical study of the lateral stability of proximal interphalangeal joint by the injury of proximal phalanx trochlea

作　　者：王少和 范红斌 史关祺 陈杨澍 高娣 金哲悟 王真 杜斌 胡一波 吴柯 Wang Shaohe;Fan Hongbin;Shi Guanqi;Chen Yangshu;Gao Di;Jin Zhewu;Wang Zhen;Du Bin;Hu Yibo;Wu Ke(Department of Human Anatomy and Histology,Wuxi School of Medicine,Jiangnan University,Wuxi214122,China;Wuxi School of Medicine,Jiangnan University,Wuxi214122,China;Wuxi Ninth People’s Hospital Affiliated to Soochow University,Wuxi 214062,China)

机构地区：[1]江南大学无锡医学院人体解剖与组织胚胎学教研室,江苏无锡214122 [2]江南大学无锡医学院,江苏无锡214122 [3]苏州大学附属无锡市第九人民医院,江苏无锡214062

出　　处：《中国临床解剖学杂志》2021年第6期635-637,共3页Chinese Journal of Clinical Anatomy

基　　金：江苏省博士后科研资助计划(2020Z359)。

摘　　要：目的通过近节指骨滑车损伤实验,探究其对近指间关节侧方稳定性影响,为治疗提供解剖依据。方法解剖6具成人双上肢手标本,选择示指、中指、环指共36只手指进行研究。分别测量0°屈曲位时近指间关节近节指骨滑车未损伤及桡侧损伤10%、20%、30%、40%、50%的桡偏角度。结果未损伤时近节指骨滑车两端长度平均为(10.25±1.12)mm,桡偏角度为(0.14±0.10)°,损伤10%时桡偏角度为(5.06±0.53)°,损伤20%时桡偏角度为(8.47±0.42)°,损伤30%时桡偏角度为(12.28±0.71)°,损伤40%时桡偏角度为(16.33±0.76)°,损伤50%时桡偏角度为(20.03±0.75)°。近节指骨滑车损伤程度越重,近指间关节桡偏角度越大,关节稳定性越差(P<0.0001,Wilcoxon检验)。结论近节指骨滑车缺损对近指间关节侧方稳定性具有显著影响,损伤达10%时即可发生侧方不稳定。Objective To provide anatomical basis for the treatment of proximal interphalangeal(PIP)joint by the injury experiment of proximal phalanx trochlea.Methods Both of the upper hand specimens from 6 adults were dissected,and 36 fingers including index finger,middle finger and ring finger were selected for the study.The radial angle of PIP joints was measured when the trochlea of proximal phalanx was intacted 10%,20%,30%,40%and 50%of injuries at 0°PIP joint flexion.Results The mean length of the two sides of the proximal phalanx was(10.25±1.12)mm,and the radial angle of PIP joints was(0.14±0.10)°.When 10%of injuries,it was(5.06±0.53)°,when 20%of injuries,it was(8.47±0.42)°,when 30%of injuries,it was(12.28±0.71)°,when 40%of injuries,it was(16.33±0.76)°,and when 50%of injuries,it was(20.03±0.75)°.The more severe the injury of the proximal phalanx trochlea,the larger the radial angle of PIP joints,meaning the more unstable the PIP joints(P<0.0001,Wilcoxon test).Conclusions The defect of the proximal phalangeal trochlea has a significant effect on the lateral stability of PIP joints.Lateral instability can occur when the injury reaches 10%.

关 键 词：近节指骨滑车 近指间关节 稳定性 应用解剖 

分 类 号：R322.7[医药卫生—人体解剖和组织胚胎学] R684[医药卫生—基础医学]