Forster R I, Sharkey N A, Szabo R M
Department of Orthopaedic Surgery, University of California, Davis, Sacramento, USA.
J Hand Surg Am. 1999 May;24(3):538-45. doi: 10.1053/jhsu.1999.0538.
Biomechanical testing was performed to determine isometric interosseous ligament graft placement as a preliminary step for reconstruction after an axial forearm disruption. Twenty-five combinations of potential ligament graft placement were studied on 7 fresh-frozen cadavers. Suture was used to simulate these potential ligament reconstructions, and suture excursion was used as an index of isometry. Ligament orientation was defined by the angle formed between the ulna and the suture (surrogate graft). Ligament position was defined by its insertion on the ulna as a percentage of ulna length. Suture-ulna angles from 9 degrees to 38 degrees produced significantly less suture excursion than angles of > or = 39 degrees. Minimal suture excursion was noted at angles of < or = 20 degrees, which we feel represents the optimal range for reconstruction. The optimal location on the ulna for isometric interosseous ligament reconstruction was at 25% to 30% of total ulna length, as measured proximally from the distal ulna articular surface. The radius isometric location is optimally located by a vector starting from the ulna isometric point and directed toward the proximal radius at an angle of < or = 20 degrees relative to the long axis of the ulna. Interosseous ligament reconstruction may prove beneficial in the long-term outcome of reconstruction after axial forearm disruption.
进行生物力学测试以确定等长骨间韧带移植物的放置位置，作为前臂轴向断裂后重建的初步步骤。在7具新鲜冷冻尸体上研究了25种潜在韧带移植物放置的组合。使用缝线模拟这些潜在的韧带重建，并将缝线偏移用作等长的指标。韧带方向由尺骨与缝线（替代移植物）之间形成的角度定义。韧带位置由其在尺骨上的插入点作为尺骨长度的百分比来定义。9度至38度的缝线-尺骨角度产生的缝线偏移明显小于≥39度的角度。在≤20度的角度处观察到最小的缝线偏移，我们认为这代表了重建的最佳范围。从尺骨远端关节面近端测量，等长骨间韧带重建在尺骨上的最佳位置是总尺骨长度的25%至30%。桡骨等长位置通过从尺骨等长点开始并相对于尺骨长轴以≤20度的角度指向桡骨近端的向量来最佳定位。骨间韧带重建可能对前臂轴向断裂后重建的长期结果有益。
