London Health Sciences Center, University Hospital, LHSC, London, Ontario, N6C 5A5, Canada.
Bone Joint J. 2013 Oct;95-B(10):1383-7. doi: 10.1302/0301-620X.95B10.31844.
We measured the tension in the interosseous membrane in six cadaveric forearms using an in vitro forearm testing system with the native radial head, after excision of the radial head and after metallic radial head replacement. The tension almost doubled after excision of the radial head during simulated rotation of the forearm (p = 0.007). There was no significant difference in tension in the interosseous membrane between the native and radial head replacement states (p = 0.09). Maximal tension occurred in neutral rotation with both the native and the replaced radial head, but in pronation if the radial head was excised. Under an increasing axial load and with the forearm in a fixed position, the rate of increase in tension in the interosseous membrane was greater when the radial head was excised than for the native radial head or replacement states (p = 0.02). As there was no difference in tension between the native and radial head replacement states, a radial head replacement should provide a normal healing environment for the interosseous membrane after injury or following its reconstruction. Load sharing between the radius and ulna becomes normal after radial head Replacement. As excision of the radial head significantly increased the tension in the interosseous membrane it may potentially lead to its attritional failure over time.
我们使用体外前臂测试系统测量了 6 个尸体前臂的骨间膜张力，其中包括切除桡骨头后的情况和金属桡骨头置换后的情况。在模拟前臂旋转时，切除桡骨头后骨间膜张力几乎增加了一倍（p = 0.007）。在天然桡骨头和桡骨头置换状态下，骨间膜张力没有显著差异（p = 0.09）。在天然和置换的桡骨头状态下，中立旋转时骨间膜张力最大，但如果切除桡骨头，则会出现旋前。在轴向负荷增加且前臂固定的情况下，切除桡骨头后骨间膜张力的增加速度大于天然桡骨头或置换状态（p = 0.02）。由于天然桡骨头和桡骨头置换状态之间的张力没有差异，因此桡骨头置换应该为骨间膜提供一个正常的愈合环境，无论是在受伤后还是在重建后。桡骨头置换后，桡骨和尺骨之间的负荷分担变得正常。由于切除桡骨头会显著增加骨间膜的张力，因此它可能会导致骨间膜随着时间的推移逐渐磨损失效。
