Saito Susumu, Suzuki Shigehiko, Suzuki Yoshihisa
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Kyoto, Japan.
J Hand Surg Am. 2012 Jul;37(7):1335-41. doi: 10.1016/j.jhsa.2012.03.004. Epub 2012 Apr 25.
To define the biomechanical differences of the volar plate (VP) of the proximal interphalangeal joint during active and passive motion, which may provide clues to understanding the functional importance of the volar elevation of the VP.
We imaged the volar aspect of the proximal interphalangeal joint in 10 healthy middle fingers using ultrasonography. Cine videos recorded the movements of the VP during joint motion from full extension to more than 60° of flexion both actively and passively. We plotted 5 points on the volar surface of the VP and traced them for motion analysis. We statistically analyzed the volar distances and volar angulation of the VP in full extension, 30°, 45°, and 60° of flexion to determine the differences between active and passive flexion.
In active flexion, the VP showed significantly higher volar distances in 45° and 60° and changed its configuration from the original flattened figure to an inverted U shape, with a significant higher angulation at 45° compared with passive flexion. Conversely, in passive flexion, we did not observe the volar elevation of the VP and the flattened configuration was maintained throughout the motion arc.
From an anatomical viewpoint, volar elevation of the VP seen in active flexion could provide dynamic stresses on the adjacent ligaments and contribute to the stability and smooth gliding of the joint.
确定近端指间关节掌板（VP）在主动和被动运动过程中的生物力学差异，这可能为理解VP掌侧抬高的功能重要性提供线索。
我们使用超声对10名健康受试者的中指近端指间关节掌侧进行成像。电影视频记录了VP在关节从完全伸展到超过60°屈曲的主动和被动运动过程中的运动。我们在VP掌侧表面绘制5个点并对其进行追踪以进行运动分析。我们对VP在完全伸展、30°、45°和60°屈曲时的掌侧距离和掌侧角度进行统计分析，以确定主动和被动屈曲之间的差异。
在主动屈曲时，VP在45°和60°时掌侧距离显著更高，其形态从原来的扁平状变为倒U形，与被动屈曲相比，在45°时角度显著更高。相反，在被动屈曲时，我们未观察到VP的掌侧抬高，并且在整个运动弧度中保持扁平形态。
从解剖学角度来看，主动屈曲时观察到的VP掌侧抬高可为相邻韧带提供动态应力，并有助于关节的稳定性和平滑滑动。
