Siegel D B, Gelberman R H
Massachusetts General Hospital, Department of Orthopaedic Surgery, Boston 02114.
J Hand Surg Am. 1991 Jan;16(1):40-4. doi: 10.1016/s0363-5023(10)80010-3.
This study determines the anatomical relationship of the radiocarpal ligaments to the radial styloid process, and the effect of three specific styloidectomies on the integrity of these ligaments. Thirty fresh cadaveric wrists were dissected. The origins, insertions, and dimensions of each ligament was determined. The thirty wrists were divided randomly into three equal groups and the ten wrists in each group had three types of styloidectomy: short oblique, vertical oblique, and horizontal. The styloid fragments and wrists were then reexamined to determine the integrity of the ligaments. All styloidectomies removed the radial collateral ligament origin. Vertical oblique styloidectomy removed additionally 92% of the radioscaphocapitate and 21% of the radiolunatotriquetral ligament. Horizontal styloidectomy removed 95% of the radioscaphocapitate, and 46% of the radiolunatotriquetral ligament. These findings indicate that the degree of radiocarpal ligament disruption that occurs after styloidectomy may be predicted accurately by correlating the amount of styloid removed, with the consistent ligamentous anatomy of this area.
本研究确定了桡腕韧带与桡骨茎突的解剖关系,以及三种特定茎突切除术对这些韧带完整性的影响。对30个新鲜尸体手腕进行了解剖。确定了每条韧带的起点、止点和尺寸。将这30个手腕随机分为三组,每组10个手腕,分别进行三种类型的茎突切除术:短斜形、垂直斜形和水平形。然后重新检查茎突碎片和手腕,以确定韧带的完整性。所有茎突切除术均切除了桡侧副韧带的起点。垂直斜形茎突切除术还切除了92%的桡舟头韧带和21%的桡月三角韧带。水平形茎突切除术切除了95%的桡舟头韧带和46%的桡月三角韧带。这些发现表明,通过将切除的茎突量与该区域一致的韧带解剖结构相关联,可以准确预测茎突切除术后发生的桡腕韧带破坏程度。