Kamineni Srinath, ElAttrache Neal S, O'driscoll Shawn W, Ahmad Christopher S, Hirohara Hirotsune, Neale Patricia G, An Kai-Nan, Morrey Bernard F
Department of Orthopaedics and Biomechanics, Imperial College London and Hillingdon Hospital NHS Trust, South Kensington Campus, London SW7 2AZ, United Kingdom.
J Bone Joint Surg Am. 2004 Nov;86(11):2424-30. doi: 10.2106/00004623-200411000-00010.
Partial resection of the posteromedial aspect of the olecranon in the treatment of valgus extension impingement osteophytosis is a well-described technique. It has been hypothesized that removal of the normal olecranon process, beyond the osteophytic margin, increases the strain in the anterior bundle of the medial collateral ligament.
We used an electromagnetic tracking device to investigate the strain in the anterior bundle of the medial collateral ligament as a function of increasing applied torque and posteromedial resections of the olecranon in seven cadaveric elbows. Applied torques under valgus stress consisted of hand weight, hand weight plus 1.75 Nm, and hand weight plus 3.5 Nm. Resections were conducted in sequential 3-mm increments, from 0 to 9 mm. We measured changes in the length of the anterior and posterior bands of the anterior bundle of the medial collateral ligament with strain gauges. The strains of the two bands were averaged, and the average was reported.
The strain in the anterior bundle of the medial collateral ligament was found to increase with increasing flexion angle, valgus torque, and olecranon resection beyond 3 mm. In two elbows, the anterior bundle of the medial collateral ligament ruptured during testing following the 9-mm resection. There was a significant difference between the strain following the 6-mm resection and that following the 3-mm resection at 110 degrees of flexion with 3.5 Nm of added torque (p = 0.004).
In this in vitro cadaver study, an increase in flexion angle, an increase in valgus torque, and resection of > or =6 mm led to an increase in strain in the anterior bundle of the medial collateral ligament. The non-uniform change in strain related to 3 mm of resection suggests that resections of the posteromedial aspect of the olecranon of >3 mm may jeopardize the function of the anterior bundle.
在治疗外翻伸展撞击性骨赘病时，尺骨鹰嘴后内侧部分切除是一种广为人知的技术。有假说认为，切除超出骨赘边缘的正常尺骨鹰嘴会增加内侧副韧带前束的应变。
我们使用电磁跟踪装置，研究了在七个尸体肘关节中，随着施加扭矩增加以及尺骨鹰嘴后内侧切除，内侧副韧带前束的应变情况。外翻应力下的施加扭矩包括手的重量、手的重量加1.75 Nm以及手的重量加3.5 Nm。切除以3毫米的增量依次进行，从0毫米到9毫米。我们用应变片测量内侧副韧带前束前后带长度的变化。将两条带的应变进行平均，并报告平均值。
发现内侧副韧带前束的应变随着屈曲角度增加、外翻扭矩增加以及尺骨鹰嘴切除超过3毫米而增加。在两个肘关节中，在9毫米切除后的测试过程中，内侧副韧带前束发生了断裂。在屈曲110度且增加3.5 Nm扭矩时，6毫米切除后的应变与3毫米切除后的应变之间存在显著差异（p = 0.004）。
在这项体外尸体研究中，屈曲角度增加、外翻扭矩增加以及切除≥6毫米会导致内侧副韧带前束的应变增加。与3毫米切除相关的应变非均匀变化表明，尺骨鹰嘴后内侧切除超过3毫米可能会损害前束的功能。
