Moojen Thybout M, Snel Jeroen G, Ritt Marco J P F, Venema Henk W, Kauer John M G, Bos Kurt E
Department of Plastic Surgery, Academic Medical Center, Amsterdam, The Netherlands.
J Hand Surg Am. 2002 Nov;27(6):1003-10. doi: 10.1053/jhsu.2002.36519.
The purpose of this study was to quantify 3-dimensional (3-D) in vivo scaphoid kinematics during flexion-extension motion (FEM) and radial-ulnar deviation (RUD) of the hand. The right wrists of 11 healthy volunteers were imaged by spiral computed tomography during RUD and 5 of those wrists also during FEM. With a matching technique, relative translations and rotations of the scaphoids were traced. Our results showed a broad spectrum of kinematic patterns of the scaphoid during RUD, with small intercarpal motions within the proximal carpal row. Some scaphoids rotated basically around the flexion-extension axis only whereas others rotated almost entirely around the deviation axis during RUD. During FEM we found highly uniform scaphoid motion patterns with large intercarpal motions within the proximal carpal row. These findings suggest that current theories cannot sufficiently explain wrist kinematics and stress the need for more in vivo studies on 3-D carpal kinematics.
本研究的目的是量化手部屈伸运动(FEM)和桡尺偏斜(RUD)过程中舟骨的三维(3-D)体内运动学。11名健康志愿者的右手腕在桡尺偏斜过程中通过螺旋计算机断层扫描成像,其中5名志愿者的手腕在屈伸运动过程中也进行了成像。采用匹配技术,追踪舟骨的相对平移和旋转。我们的结果显示,在桡尺偏斜过程中舟骨的运动学模式范围广泛,近端腕骨排内的腕骨间运动较小。在桡尺偏斜过程中,一些舟骨基本仅围绕屈伸轴旋转,而另一些舟骨几乎完全围绕偏斜轴旋转。在屈伸运动过程中,我们发现舟骨的运动模式高度一致,近端腕骨排内的腕骨间运动较大。这些发现表明,当前的理论无法充分解释腕关节运动学,并强调需要进行更多关于三维腕骨运动学的体内研究。