桡骨远端乙状切迹对远端尺桡关节稳定性影响的CT图像评价  

Effect of sigmoid notch of distal radius on the stability of distal radioulnar joint based on CT images

作　　者：尚子健 郭林[2] 王植[2] 孟祥虹[2] 陈菲[2] 张雪君[1] Shang Zijian;Guo Lin;Wang Zhi;Meng Xianghong;Chen Fei;Zhang Xuejun(Tianjin Medical University,Tianjin 300070,China;Tianjin Hospital,Tianjin 300211,China)

机构地区：[1]天津医科大学,天津市300070 [2]天津市天津医院,天津市300211

出　　处：《中国组织工程研究》2023年第27期4357-4361,共5页Chinese Journal of Tissue Engineering Research

基　　金：天津市卫生健康委员会科技项目(ZC20018),项目负责人:郭林。

摘　　要：背景:有研究表明尺桡骨的骨性解剖结构对于远端尺桡关节稳定性有一定作用,尤其是桡骨远端乙状切迹的形态。既往研究多集中于尸体研究或者生物力学研究,而很少有研究利用影像学方法评估形态学对于远端尺桡关节稳定性的影响。目的:应用CT评价不同形状桡骨远端乙状切迹对远端尺桡关节稳定性的影响。方法:回顾性分析151例患者腕部和前臂CT图像,根据桡骨远端乙状切迹在轴位CT图像上的形态学特征,将其分为“Flat”“Ski”“C”“S”4种形状,并进行卡方分割检验比较4型切迹之间的差异。根据临床诊断是否存在远端尺桡关节失稳,将其分为失稳组和稳定组,比较不同形态桡骨乙状切迹对远端尺桡关节稳定性的影响。结果与结论:(1)腕部损伤患者共151例,男性77例,女性74例,平均年龄39.0(55.0-32.0)岁,Flat型、Ski型、C型、S型桡骨乙状切迹分别为42例(27.8%),47例(31.1%),39例(25.8%),23例(15.2%);(2)按照临床诊断分为远端尺桡关节失稳组与稳定组,其中失稳组85例(56.3%),包括Flat型27例,Ski型30例,C型11例,S型17例;稳定组66例(43.7%),包括Flat型15例,Ski型17例,C型28例,S型6例;(3)统计学结果显示不同形态的桡骨远端乙状切迹对于远端尺桡关节稳定性存在统计学差异(Pearson χ^(2)=17.583,P=0.001);C型乙状切迹的远端尺桡关节失稳率最低,且与另外3型存在统计学差异;而Flat型、S型、Ski型乙状切迹的远端尺桡关节失稳率较高,3型间无统计学差异;(4)由此可见,Ski型和Flat型桡骨远端乙状切迹最常见,而C型桡骨远端乙状切迹有利于维持远端尺桡关节稳定性。BACKGROUND: Studies have shown that the bony anatomy of the radius and ulna plays a role in the stability of the distal radioulnar joint, especially the shape of the distal radius sigmoid notch. Previous studies have mostly focused on cadaver studies or biomechanical studies, while few studies have used imaging methods to assess the effect of morphology on the stability of the distal radioulnar joint.OBJECTIVE: To assess the effect of different shapes of sigmoid notch of distal radius on the stability of distal radioulnar joint by CT.METHODS: The CT images of wrist and forearm of 151 cases were analyzed retrospectively. According to the morphological characteristics of the sigmoid notch of the distal radius on the axial CT image, it was divided into four shapes “Flat”, “Ski”, “C” and “S”. The chi-square test was used to compare the differences between the 4-type notch. According to the clinical diagnosis of distal radioulnar joint instability, they were divided into instability group and stability group to compare the effects of different forms of radial sigmoid notch on the stability of distal radioulnar joint.RESULTS AND CONCLUSION:(1) There were 151 patients with wrist injury, including 77 males and 74 females, with an average age of 39.0(55.0-32.0) years.There were 42 cases of Flat type radial sigmoid notch(27.8%), 47 cases of Ski type radial sigmoid notch(31.1%), 39 cases of C type radial sigmoid notch(25.8%),and 23 cases of S type radial sigmoid notch(15.2%).(2) According to the clinical diagnosis, the patients were divided into distal radioulnar joint instability group and stability group. There were 85 cases(56.3%) in the instability group, including 27 cases of Flat type, 30 cases of Ski type, 11 cases of C type and 17 cases of S type. There were 66 cases(43.7%) in the stable group, including 15 cases of Flat type, 17 cases of Ski type, 28 cases of C type and 6 cases of S type.(3) The statistical results showed that there were significant differences in the stability of distal radioulnar

关 键 词：桡骨远端 远端尺桡关节 乙状切迹 CT 稳定性 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R445.3