Crisco Joseph J, Pike Sandi, Hulsizer-Galvin Dina L, Akelman Edward, Weiss Arnold Peter C, Wolfe Scott W
Department of Orthopaedics, Brown Medical School and Rhode Island Hospital, Providence, RI, USA.
J Hand Surg Am. 2003 Nov;28(6):926-37. doi: 10.1016/s0363-5023(03)00422-2.
The recent ability to measure 3-dimensional in vivo carpal kinematics has facilitated the noninvasive study of complex carpal bone motion.
In this study we examined the flexion/extension carpal kinematics of both wrists in 8 patients with unilateral scapholunate interosseous ligament (SLIL) tears by using computed tomographic (CT) imaging and a markerless bone registration technique. Carpal bone neutral posture and flexion/extension motion of both wrists of the injured patients were compared with the same parameters in wrists of 10 uninjured male and female volunteers (normals).
The neutral posture of the injured scaphoid and lunate were significantly more extended than those of normals. In these patients, however, the postures of the scaphoid and lunate in the contralateral uninjured wrists also were abnormal and were similar to those of the injured wrist. In addition, extension of the lunate and flexion of the scaphoid in both the injured and uninjured wrist were significantly different from normal but not different from each other.
This study was unable to attribute altered carpal posture and motion to SLIL tears because abnormalities were found in both wrists of patients with unilateral injury. The etiology of abnormal wrist kinematics in the asymptomatic wrist of patients with unilateral tears of the scapholunate ligament is not known.
近期测量体内腕骨三维运动学的能力促进了对复杂腕骨运动的非侵入性研究。
在本研究中,我们通过计算机断层扫描(CT)成像和无标记骨配准技术,检查了8例单侧舟月骨间韧带(SLIL)撕裂患者双腕的屈伸腕骨运动学。将受伤患者双腕的腕骨中立位姿势和屈伸运动与10名未受伤的男性和女性志愿者(正常对照)双腕的相同参数进行比较。
受伤舟骨和月骨的中立位姿势明显比正常对照更伸展。然而,在这些患者中,对侧未受伤腕部的舟骨和月骨姿势也异常,且与受伤腕部相似。此外,受伤和未受伤腕部的月骨伸展和舟骨屈曲均与正常对照有显著差异,但彼此之间无差异。
本研究无法将腕骨姿势和运动改变归因于SLIL撕裂,因为单侧损伤患者的双腕均发现异常。舟月韧带单侧撕裂患者无症状腕部腕关节运动学异常的病因尚不清楚。