当前位置: X-MOL 学术Clin. Biomech. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Biomechanical analysis of simultaneous distal and proximal radio-ulnar joint instability.
Clinical Biomechanics ( IF 1.8 ) Pub Date : 2020-06-07 , DOI: 10.1016/j.clinbiomech.2020.105074
Naoki Hayami 1 , Shohei Omokawa 2 , Tsutomu Kira 3 , Junya Hojo 4 , Pasuk Mahakkanukrauh 5 , Yasuhito Tanaka 3
Affiliation  

Background

Simultaneous dislocation of the proximal and distal radio-ulnar joints without bony injuries has been reported, but the mechanism remains unclear. We investigated concurrent proximal and distal radio-ulnar joint instability after sequential sectioning of the annular ligament, triangular fibrocartilage complex, and quadrate ligament.

Methods

We performed this biomechanical study with six fresh-frozen cadaveric upper extremities. Proximal and distal radio-ulnar joint displacement was measured using an electromagnetic tracking device during passive mobility testing with anterior, lateral, and posterior loads on the radial head with pronation, supination, and neutral rotation. Measurements were statistically analyzed using the generalized linear mixed model.

Findings

Proximal radio-ulnar joint instability was significantly greater after sectioning of the annular (lateral: 1.4%, P < .05; posterior: 0.7%, P < .05) and quadrate (lateral: 43.7%, P < .05; posterior: 29.5%, P < .05) ligament. Distal radio-ulnar joint instability was significantly greater in every sequential stage (final stage: anterior: 24.1%, P < .05; lateral 21.0%, P < .05; posterior: 31.3%, P < .05). Finally, significant simultaneous instability of the joints was observed after sectioning of the annular ligament, triangular fibrocartilage complex, and quadrate ligament, and neutral rotation potentially induced gross instability.

Interpretation

Our ligament injury model induced simultaneous proximal and distal radio-ulnar joint instability without bony or interosseous membrane injury, probably induced by severe soft tissue injury. Proximal radio-ulnar joint instability may influence distal radio-ulnar joint instability from pivoting of the interosseous membrane. Our findings will help surgeons evaluate the magnitude of soft tissue injury and plan surgery for patients with simultaneous proximal and distal radio-ulnar joint instability.



中文翻译:

同时远端和近端放射性尺骨关节不稳的生物力学分析。

背景

据报道,近端和远端尺-关节同时脱位,无骨损伤,但机制尚不清楚。我们研究了环形韧带,三角纤维软骨复合体和四边形韧带的连续切片后并发的近端和远端放射性尺骨关节的不稳定性。

方法

我们用六个新鲜冷冻的尸体上肢进行了这项生物力学研究。在被动活动性测试过程中,使用前向,向后旋转和中性旋转的the骨头在前,侧和后方进行负荷的被动活动性测试期间,使用电磁跟踪设备测量了近端和远端radio尺关节的位移。使用广义线性混合模型对测量进行统计分析。

发现

切成环形后(侧面:1.4%,P  <.05;后方:0.7%,P  <.05)和正方形(侧面:43.7%,P  <.05;后方: 29.5%,P  <.05)韧带。在每个连续阶段,远端尺radio远端关节不稳定性明显增加(最终阶段:前位:24.1%,P  <.05;外侧位:21.0%,P  <.05;后位:31.3%,P  <.05)。最后,在切开环形韧带,三角纤维软骨复合体和四边形韧带后,观察到关节明显同时不稳定,并且中性旋转可能引起严重的不稳定。

解释

我们的韧带损伤模型可诱发同时发生的近端和远端尺尺radio关节不稳定性,而无骨或骨间膜损伤,这可能是由严重的软组织损伤引起的。近端尺尺joint关节不稳定性可能会由于骨间膜的旋转而影响远端尺尺radio关节的不稳定性。我们的发现将有助于外科医生评估软组织损伤的程度,并为同时发生近端和远端放射性尺骨关节不稳的患者计划手术。

更新日期:2020-06-07
down
wechat
bug