反向Sauvé-Kapandji技术的标本模型建立及生物力学测试  

The specimen establishment and biomechanical verification of reverse Sauvé-Kapandji technique

作　　者：杨辰 刘路 陈山林 YANG Chen;LIU Lu;CHEN Shan-lin(Department of Hand Surgery,Beijing Jishuitan Hospital,Capital Medical University,Beijing,100035,China)

机构地区：[1]首都医科大学附属北京积水潭医院手外科,北京100035

出　　处：《中国骨与关节杂志》2023年第7期522-525,共4页Chinese Journal of Bone and Joint

基　　金：北京市自然科学基金-海淀原始创新联合基金资助项目(L192052)。

摘　　要：目的 反向Sauvé-Kapandji技术是一种治疗先天性上尺桡融合的新手术技术。临床结果显示该手术方法可较好地改善患肢前臂旋转功能受限的问题,但该术式的治疗效果尚无生物力学研究作为基础支持。本研究对前臂标本进行反向Sauvé-Kapandji手术,分析其生物力学机制及其效果。方法 使用6例冰冻前臂标本,随机分成实验组及对照组,实验组固定肱尺关节和上尺桡关节,建立上尺桡融合标本模型。对标本施行反向Sauvé-Kapandji手术操作,分别记录各标本的最大旋前及旋后角度,使用t检验评估实验组与对照组间前臂旋转角度差异是否有统计学意义。结果 对照组中,正常平均最大旋前角度为76°(60°~84°),平均最大旋后角度为91.7°(85°~100°),最大平均旋转角度为167.7°(145°~174°)。实验组施行反向Sauvé-Kapandji术后,平均最大旋前角度为67°(60°~78°),平均最大旋后角度为84.5°(70°~90°),最大平均旋转角度为151.5°(135°~168°)。两组标本的旋转范围、旋前、旋后差异无统计学意义(P <0.05)。结论 反向Sauvé-Kapandji技术能有效解决上尺桡融合患者前臂旋转功能受限的问题,且术后前臂旋转功能可接近正常。Objective The reverse Sauvé-kapandji technique is a new surgical technique for the treatment of congenital radioulnar synostosis.Clinical experience shows that the rotation function of the affected forearm was greatly improved postoperatively.However,there is no biomechanical study to support this new treatment.In this study,reverse Sauvé-kapandji surgery was performed on forearm specimens to evaluate the effect of this surgical technique.Methods Six frozen forearm specimens were randomly divided into experimental group and control group.The humeroulnar joint and proximal radioulnar joint were fixed with kirschner wire in the surgical group.The maximum pronation and supination angles of each specimen were recorded postoperatively.Sample t test was used to evaluate the statistical differences in forearm rotation angle between the experimental group and the control group.Results In the control group,the average maximum pronation angle,supination angle and rotation angle were 76°( 60°-84°),91.7°( 85°-100°),167.7°( 145°-174°),respectively.In the experimental group,the average maximum pronation angle,supination angle and rotation angle were 67°( 60°-78°),84.5°( 70°-90°),151.5°( 135°-168°),respectively.There was no significant difference in rotation range,pronation and supination angle between the two groups( P<0.05).Conclusions Reverse Sauvé-Kapandji technique can greatly improve the forearm rotation range in patients with proximal radioulnar synostosis,and the forearm rotation function can be close to normal after operation.

关 键 词：桡腕关节 关节融合术 腕关节 反向Sauvé-Kapandji技术 

分 类 号：R683.4[医药卫生—骨科学] R687.3[医药卫生—外科学]