摘要
目的 研究临床常用的部分腕骨融合术或切除术对腕关节运动的影响程度。方法 将 12侧新鲜上肢处理后 ,固定于特制的测试架上 ,在腕背部打入 2根或多根克氏针 ,分别作舟头骨、舟大小多角骨、舟月骨、月三角骨、舟月三角骨、桡月骨、桡舟月骨、fourcorner、头月骨融合术、舟骨切除 +fourcorner、舟骨切除 +头月融合术。观测腕关节正常运动活动范围 ,及作上述不同部分腕骨融合术后腕关节屈曲、伸腕、尺偏、桡偏度数。结果 桡舟月骨融合对腕关节屈伸影响最大 ,屈曲比正常减少 46.3 % ,伸腕减少 3 7.7% ;fourcorner融合术对腕关节桡尺偏影响最大 ,桡偏比正常减少 5 3 .9% ,尺偏减少 2 6.5 % ;月三角骨融合术对腕关节运动影响最小。结论 近排腕骨与桡骨融合术对腕关节屈伸影响最大 ,远近排腕骨融合术对尺桡偏影响最大。
Objective To study the influence of limited intercarpal arthrodesis or carpectomy on global wrist motion.Methods 12 fresh frozen human forearm specimens were used in this investigation. The specimen was placed into a jig specially designed for range of motion measurements. Scaphoid capitate, scaphoid trapezium trapezoid, scaphoid lunate, lunate triquetrum, scaphoid lunate triquetrum, radio lunate, radio scaphoid lunate, capitate lunate, and four corner fusion was done by drilling two or more Kirschner wires across the intercarpal joints. Scaphoid excision + four corner fusion and scaphoid excision + capitate lunate fusion were also done. The wrist was moved passively and the range of wrist flexion, extension, radial deviation, and ulnar deviation was checked before and after these operations.Results Wrist flexion and extension motion reduced most significantly after simulated radio scaphoid lunate fusion. Wrist flexion reduced by 46.3 %, while wrist extension reduced by 37.7 %. Wrist ulnar and radial deviation motions reduced most significantly after simulated four corner arthrodesis, being 53.9 % less than normal radial deviation and 26.5 % less than normal ulnar deviation. Wrist motion was least influenced by simulated lunate triquetrum fusion.Conclusions Arthrodesis of radius and proximal row carpal bones impaired wrist flexion and extension most significantly. Ulnar and radial deviation of the wrist reduced most significantly after fusion of mid intercarpal joint.
出处
《中华手外科杂志》
CSCD
2000年第3期178-180,共3页
Chinese Journal of Hand Surgery
