Gofton Wade T, Gordon Karen D, Dunning Cynthia E, Johnson James A, King Graham J W
Bioengineering Laboratory, Hand and Upper Limb Centre, St. Joseph's Health Centre, Department of Surgery and Biomedical Engineering, University of Western Ontario, London, Ontario, Canada.
J Hand Surg Am. 2005 Jul;30(4):733-42. doi: 10.1016/j.jhsa.2004.12.008.
Distal radioulnar joint (DRUJ) instability can result in pain and functional disability. Numerous DRUJ reconstructive options have been described with minimal biomechanical analysis. The purpose of this study was to evaluate the ability of 4 well-described DRUJ reconstructions to restore joint kinematics using a dynamic, motion-controlled simulator.
Eleven cadaveric upper extremities had computer-controlled simulated active forearm rotation. Joint kinematics were quantified by using an electromagnetic tracking system. We compared the passive and simulated active kinematics of the intact, unstable, and reconstructed DRUJ (capsular repair, 2 described radioulnar ligament reconstructions, and a radioulnar tethering procedure).
All reconstructions improved significantly the kinematics of the unstable DRUJ. The capsule repair restored simulated active joint kinematics closest to the intact DRUJ.
All 4 reconstructions improved DRUJ stability significantly. The capsule repair most closely matched intact DRUJ kinematics and the radioulnar ligament reconstructions were found to be superior to a radioulnar tethering procedure.
桡尺远侧关节（DRUJ）不稳定可导致疼痛和功能障碍。虽然已有多种DRUJ重建方法被描述，但生物力学分析较少。本研究的目的是使用动态、运动控制模拟器评估4种已详细描述的DRUJ重建方法恢复关节运动学的能力。
对11具尸体上肢进行计算机控制的模拟主动前臂旋转。使用电磁跟踪系统对关节运动学进行量化。我们比较了完整、不稳定和重建的DRUJ（关节囊修复、2种已描述的桡尺韧带重建和一种桡尺束缚手术）的被动和模拟主动运动学。
所有重建方法均显著改善了不稳定DRUJ的运动学。关节囊修复恢复的模拟主动关节运动学最接近完整的DRUJ。
所有4种重建方法均显著提高了DRUJ的稳定性。关节囊修复与完整DRUJ的运动学最匹配，且发现桡尺韧带重建优于桡尺束缚手术。
