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腕关节桡尺偏斜时选定腕骨韧带的体内长度变化

In vivo length changes of selected carpal ligaments during wrist radioulnar deviation.

作者信息

Xu Jing, Tang Jin Bo

机构信息

Department of Hand Surgery, Hand Surgery Research Center, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.

出版信息

J Hand Surg Am. 2009 Mar;34(3):401-8. doi: 10.1016/j.jhsa.2008.11.013.

Abstract

PURPOSE

To investigate changes in the lengths of selected carpal ligaments during wrist radioulnar deviation in vivo.

METHODS

We studied in vivo changes in the lengths of fibers of 5 palmar and dorsal intracapsular ligaments of the wrist during radioulnar deviation in 6 wrists of healthy volunteers using a noninvasive approach. Using serial computed tomography scans and volume registration techniques, the carpal kinematics were examined at 4 positions, from 40 degrees ulnar deviation to 20 degrees radial deviation, in 20 degrees increments. The 3-dimensional structures of the carpal bones, distal radius and ulna, and metacarpal bones were reconstructed using customized software. We modeled the paths of fibers of 5 palmar and dorsal carpal ligaments: radioscaphocapitate (RSC), long radiolunate (LRL), ulnocapitate (UC), dorsal intercarpal (DIC), and dorsal radiocarpal (DRC) ligaments. We analyzed changes in the lengths of these ligaments during wrist radioulnar deviation.

RESULTS

During wrist ulnar deviation, the RSC, LRL, and DIC ligaments lengthened significantly. During radial deviation, the UC and DRC ligaments lengthened significantly. Compared with their lengths at the neutral position of the carpus, the LRL ligament showed the greatest elongation rate at wrist ulnar deviation, and the DRC ligament showed the greatest elongation rate at wrist radial deviation among the 5 ligaments studied.

CONCLUSIONS

Among ligaments measured, the RSC, LRL, and DIC ligaments are tensed during wrist ulnar deviation. The UC and DRC ligaments are tensed during wrist radial deviation. Results of this in vivo study suggest that radial or ulnar deviation may predispose some carpal ligaments to excessive tensile load. The finding that the ligaments undergo different elongation rates during wrist motion may also indicate their roles in maintaining normal wrist kinematics.

摘要

目的

研究在体情况下腕关节桡尺偏斜时选定腕韧带长度的变化。

方法

我们采用无创方法,对6名健康志愿者的6个腕关节在桡尺偏斜过程中5条掌侧和背侧关节囊内韧带纤维的长度进行了在体研究。利用系列计算机断层扫描和体积配准技术,在从尺偏40度到桡偏20度的4个位置,以20度的增量检查腕关节的运动学。使用定制软件重建腕骨、桡骨远端和尺骨以及掌骨的三维结构。我们模拟了5条掌侧和背侧腕韧带纤维的路径:桡舟头韧带(RSC)、长桡月韧带(LRL)、尺头韧带(UC)、背侧腕间韧带(DIC)和背侧桡腕韧带(DRC)。我们分析了这些韧带在腕关节桡尺偏斜过程中的长度变化。

结果

在腕关节尺偏时,RSC、LRL和DIC韧带显著延长。在桡偏时,UC和DRC韧带显著延长。在所研究的5条韧带中,与腕关节中立位时的长度相比,LRL韧带在腕关节尺偏时伸长率最大,DRC韧带在腕关节桡偏时伸长率最大。

结论

在所测量的韧带中,RSC、LRL和DIC韧带在腕关节尺偏时紧张。UC和DRC韧带在腕关节桡偏时紧张。这项在体研究结果表明,桡偏或尺偏可能使一些腕韧带承受过大的拉伸负荷。韧带在腕关节运动过程中经历不同伸长率的发现也可能表明它们在维持正常腕关节运动学中的作用。

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