Van Heest A E, Sathy M, Schutte L
Department of Orthopaedic Surgery, University of Minnesota Hospital, Minneapolis 55455, USA.
J Hand Surg Am. 1999 May;24(3):614-8. doi: 10.1053/jhsu.1999.0614.
The purpose of this study is to report the biomechanics of the supination effect of the pronator teres rerouting procedure and to determine the optimum insertion point for the transfer using a cadaveric model. Pronator teres rerouting procedures were performed on 5 fresh-frozen above-elbow cadaver specimens mounted in a forearm rotation mounting frame. The pronator teres was detached from its native insertion and tested at 6 insertions on the radius. The amount of rotation of the forearm was measured after loading of the pronator teres muscle for each insertion site. The experiments were repeated by placing the pronator teres 1 cm proximal to the 6 experimental insertion sites for a total testing of 12 insertions. The results of this study show that placement of the pronator teres through the interosseous membrane, around the radius, with reinsertion onto the volar surface produced the greatest amount of forearm supination. Rerouting of the pronator teres tendon produces supination through a windlass effect when the tendon is rerouted through an interosseous window and reinserted onto its original insertion or onto the volar surface of the radius. Placement of the insertion 1 cm proximal on the radius did not affect the amount of forearm supination compared with 6 original insertion sites.
本研究的目的是报告旋前圆肌转位手术旋后效应的生物力学，并使用尸体模型确定转移的最佳插入点。对安装在前臂旋转安装框架中的5个新鲜冷冻的肘上尸体标本进行旋前圆肌转位手术。将旋前圆肌从其原始插入点分离，并在桡骨上的6个插入点进行测试。在每个插入点加载旋前圆肌后测量前臂的旋转量。将旋前圆肌放置在6个实验插入点近端1 cm处重复实验，总共测试12个插入点。本研究结果表明，旋前圆肌穿过骨间膜、绕过桡骨并重新插入掌侧表面时，产生的前臂旋后量最大。当旋前圆肌肌腱穿过骨间窗重新插入其原始插入点或桡骨掌侧表面时，通过绞盘效应产生旋后。与6个原始插入点相比，插入点在桡骨近端1 cm处并不影响前臂旋后量。
