Roloff Isabelle, Schöffl Volker Rainer, Vigouroux Laurent, Quaine Franck
Institute of Medical Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Marienplatz 4, 96050 Bamberg, Germany.
J Biomech. 2006;39(5):915-23. doi: 10.1016/j.jbiomech.2005.01.028.
A mathematical model proposed by Hume et al., 1991. Journal of Hand Surgery-American Volume 16, 722-730 for the determination of the forces acting on the A2 and A4 pulley was used. The parameters necessary for this determination include the angle of flexion, the positioning of the pulley with respect to the centre of rotation in the proximal interphalangeal joint (PIP), the relative mismatch between bone and tendon width at the location of the respective pulleys as well as the tendon height at this position. This model was further developed to include the stiffness of the respective pulley, as well as the fact, that there are two flexor tendons of which only one passes through both pulleys. Each parameter was then evaluated using a sensitivity analysis proposed by Fasham et al., 1990. Journal of Marine Research 48, 591-639 in order to determine their relative importance for the outcome of the model. The most important parameter proofed to be the positioning of the pulley with respect to the centre of rotation in the PIP joint. This observation enabled us to give the best possible placement for a pulley graft after pulley rupture.
采用了休姆等人于1991年提出的一个数学模型（《美国手外科杂志》第16卷，722 - 730页）来确定作用于A2和A4滑车的力。该确定所需的参数包括屈曲角度、滑车相对于近端指间关节（PIP）旋转中心的位置、各滑车位置处骨与肌腱宽度的相对不匹配以及该位置处的肌腱高度。此模型进一步发展，纳入了各滑车的刚度，以及存在两条屈肌腱且只有一条穿过两个滑车这一事实。然后，使用法沙姆等人于1990年提出的敏感性分析（《海洋研究杂志》第48卷，591 - 639页）对每个参数进行评估，以确定它们对模型结果的相对重要性。最重要的参数被证明是滑车相对于PIP关节旋转中心的位置。这一观察结果使我们能够在滑车断裂后给出滑车移植的最佳可能位置。
