Chantelot C, Wavreille G, Dos Remedios C, Landejerit B, Fontaine C, Hildebrand H
Department of Hand and Upper Limb Surgery, Lille University Hospital, Lille Cedex, France.
Surg Radiol Anat. 2008 Mar;30(2):103-11. doi: 10.1007/s00276-007-0297-y. Epub 2008 Jan 29.
The use of Fuji films is simple but their manipulation and result interpretation seem to be difficult in the framework of medical research. The reliability and reproducibility of Fuji films have been proved by many previous studies. This study was undertaken to know precisely the articular zones of the elbow and to determine the compressive stress these areas undergo during different activities, in order to assess the importance of different articular contact areas. These data indicate the need for better-adapted elbow prosthesis and can be eventually used to design more durable prosthesis for the elbow. The compressive stress on the radial head was less than 25% in extension. The stress on the radial head varied from the neutral position (23% of the stress), to full pronation (11% of the stress) and to full supination (6% of the stress). The Humero-ulnar compartment had the maximum impact. Coronoid process seemed to be a fundamental element of the elbow joint in extension (60% of total compressive stress). The Medial humero-ulnar compartment was less stressed than the lateral compartment. The radial head does not seem to play a major role in the stability of the elbow in extension if the ulnar collateral ligament exists. The ulnar collateral ligament is essential to the elbow joint stability. The lifespan of a non-constrained prosthesis would depend on the existence of the couple: radial head/ulnar collateral ligament; the absence of radial head could compromise the humero-ulnar stability. This work paved the way for the designing of new non-constrained elbow prosthesis with the reconstruction of the radial head.
富士胶片的使用很简单，但在医学研究框架内，其操作和结果解读似乎很困难。许多先前的研究已经证明了富士胶片的可靠性和可重复性。本研究旨在精确了解肘部的关节区域，并确定这些区域在不同活动中所承受的压应力，以评估不同关节接触区域的重要性。这些数据表明需要更好适配的肘部假体，并最终可用于设计更耐用的肘部假体。在伸展时，桡骨头的压应力小于25%。桡骨头的应力从中立位置（应力的23%）到完全旋前（应力的11%）再到完全旋后（应力的6%）有所变化。肱尺关节间室的影响最大。在伸展时，冠状突似乎是肘关节的一个基本要素（占总压应力的60%）。肱尺内侧关节间室的应力小于外侧关节间室。如果存在尺侧副韧带，桡骨头在伸展时的肘关节稳定性中似乎不起主要作用。尺侧副韧带对肘关节稳定性至关重要。非限制型假体的使用寿命将取决于桡骨头/尺侧副韧带这一组合的存在；桡骨头的缺失可能会损害肱尺关节的稳定性。这项工作为设计带有桡骨头重建的新型非限制型肘部假体铺平了道路。
