Moritomo Hisao, Apergis Emmanuel P, Garcia-Elias Marc, Werner Frederick W, Wolfe Scott W
Yukioka Hospital Hand Center, Osaka Yukioka College of Health Science, Osaka, Japan; Department of Orthopedics, Red Cross Hospital, Athens, Greece; Institut Kaplan, Barcelona, Spain; Department of Orthopedic Surgery, State University of New York, Syracuse, NY; Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY.
Yukioka Hospital Hand Center, Osaka Yukioka College of Health Science, Osaka, Japan; Department of Orthopedics, Red Cross Hospital, Athens, Greece; Institut Kaplan, Barcelona, Spain; Department of Orthopedic Surgery, State University of New York, Syracuse, NY; Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY.
J Hand Surg Am. 2014 Jul;39(7):1433-9. doi: 10.1016/j.jhsa.2014.02.035.
This report updates information on wrist dart-throwing (DT) motion, based on the most recent research published on the kinematics, kinetics, and clinical applications of DT motion. A wide range of DT planes exists. "Pure" DT motion is done along an oblique plane that intercepts the coronal and sagittal planes at the zero position, and occurs almost exclusively at the midcarpal joint with near zero scaphoid and lunate motion. "Functional" DT motion such as a hammering is done along an oblique plane that is almost parallel to the pure DT plane, but that has an offset toward the dorsal side. Functional DT rotation has greater scaphoid and lunate motion compared with pure DT motion. Midcarpal arthrodesis adversely affects DT motion compared with radiocarpal arthrodesis. During a DT motion, the mean and peak tendon forces of the flexor carpi ulnaris and the extensor carpi radialis longus were the greatest among wrist motors. By performing a task along the plane of DT motion, the scapholunate (SL) joint was stable and SL ligament elongation was minimal in healthy subjects. However, a more recent study of patients with SL dissociation revealed that DT exercises applied tensile forces on the SL ligament and induced an SL gap.
本报告基于最近发表的关于腕部掷镖(DT)运动的运动学、动力学和临床应用的研究,更新了有关腕部掷镖运动的信息。存在多种DT平面。“纯”DT运动是沿着一个在零位置与冠状面和矢状面相交的斜平面进行的,并且几乎完全发生在腕中关节,舟骨和月骨的运动近乎为零。“功能性”DT运动,如锤击,是沿着一个几乎与纯DT平面平行,但向背侧偏移的斜平面进行的。与纯DT运动相比,功能性DT旋转时舟骨和月骨的运动更大。与桡腕关节融合术相比,腕中关节融合术对DT运动有不利影响。在DT运动期间,尺侧腕屈肌和桡侧腕长伸肌的平均和峰值肌腱力在腕部肌肉中是最大的。在健康受试者中,通过在DT运动平面上执行任务,舟月(SL)关节稳定,SL韧带伸长最小。然而,最近一项对SL分离患者的研究表明,DT练习会对SL韧带施加拉力并导致SL间隙。