Matsuki Keisuke, Sugaya Hiroyuki, Takahashi Norimasa, Tokai Morihito, Ueda Yusuke, Hoshika Shota, Hamada Hiroshige, Banks Scott A
Sports Medicine and Joint Center, Funabashi Orthopaedic Hospital, 1-833 Hasama, Funabashi, Chiba 2740822, Japan; Department of Mechanical & Aerospace Engineering, University of Florida, 330 MAE-A P.O. Box 116250, Gainesville, FL 32611-6250, USA.
Sports Medicine and Joint Center, Funabashi Orthopaedic Hospital, 1-833 Hasama, Funabashi, Chiba 2740822, Japan.
J Biomech. 2020 Dec 2;113:110120. doi: 10.1016/j.jbiomech.2020.110120. Epub 2020 Nov 9.
Distal biceps tendon ruptures have been reported to be associated with narrowing of the proximal radioulnar space. There have been no studies that three-dimensionally measured the distance between the bicipital tuberosity and the proximal ulna during active motion. The purpose of this study was to three-dimensionally measure the proximal radioulnar space during active forearm pronation in healthy subjects. Five healthy volunteers (10 forearms) were recruited for this study. They consisted of all males with a mean age of 37 years (range, 34-46 years). Lateral fluoroscopy of forearm rotation from maximum supination to maximum pronation was recorded for both forearms. Three-dimensional forearm kinematics were determined using model-image registration techniques with fluoroscopic images and CT-derived bone models, and the closest distance between the bicipital tuberosity and the proximal ulna was computed at each 30° increment of radial axial rotation relative to the distal humerus. The distance between the bicipital tuberosity and the proximal ulna decreased with pronation, reaching a minimum value at 90° of radial rotation (average 4.6 ± 1.3 mm), then increased with further rotation to maximum pronation (P = 0.004). The clearance between the proximal radioulnar space and the distal biceps tendon is very small (<1mm). Hypertrophy of the bicipital tuberosity or tendon can induce impingement and lead to tendon rupture.
据报道，肱二头肌远端肌腱断裂与近端桡尺间隙变窄有关。目前尚无研究在主动运动过程中对肱二头肌结节与尺骨近端之间的距离进行三维测量。本研究的目的是对健康受试者在主动前臂旋前过程中的近端桡尺间隙进行三维测量。本研究招募了5名健康志愿者（10条前臂）。他们均为男性，平均年龄37岁（范围34 - 46岁）。记录了两条前臂从最大旋后到最大旋前的前臂旋转侧位透视影像。使用模型 - 图像配准技术结合透视影像和CT衍生的骨骼模型确定三维前臂运动学，并在相对于肱骨远端的桡骨轴向旋转每增加30°时计算肱二头肌结节与尺骨近端之间的最短距离。肱二头肌结节与尺骨近端之间的距离随着旋前而减小，在桡骨旋转90°时达到最小值（平均4.6±1.3毫米），然后随着进一步旋转至最大旋前而增加（P = 0.004）。近端桡尺间隙与肱二头肌远端肌腱之间的间隙非常小（<1毫米）。肱二头肌结节或肌腱的肥大可导致撞击并导致肌腱断裂。
