Shin Seung-Han, Park Taeyong, Hong Eunah, Kwak Dai-Soon, Chung Yang-Guk
Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Yonseihun Hospital, Gwangmyeong-si 14236, Korea.
Healthcare (Basel). 2022 Apr 30;10(5):828. doi: 10.3390/healthcare10050828.
The purpose of this study was to investigate whether a watch-shaped external wrist band brace improves distal radioulnar joint (DRUJ) stability. Seven fresh cadaveric arms were used. Using a customized testing system, volar and dorsal translation forces were applied to the radius externally while the ulna was fixed. The test was performed with the forearm in neutral, 60° pronated, and 60° supinated positions, once without the brace and once with the brace applied. In each condition, the amount of translation was measured. Then, the triangular fibrocartilage complex (TFCC) was detached from the ulnar styloid process and the fovea ulnaris, and the same tests were performed again. Detachment of the TFCC significantly increased volar and dorsal translations in all forearm rotations compared to the intact condition (p < 0.05), except for the pronated dorsal translation of the radius (p = 0.091). Brace application significantly reduced volar and dorsal translations in all forearm rotations both in intact specimens and in TFCC-detached specimens (p < 0.05), except for pronated volar and dorsal translations in TFCC-detached specimens (p = 0.101 and p = 0.131, respectively). With the brace applied, the TFCC-detached specimens showed no significant difference in volar or dorsal translation in all forearm rotations compared to the intact specimens (p > 0.05). The external wrist band brace improved DRUJ stability in both normal and TFCC-torn wrists and reduced the DRUJ instability caused by TFCC tear to a near-normal level.
本研究的目的是调查一种手表形状的腕部外侧支具是否能改善桡尺远侧关节(DRUJ)的稳定性。使用了七只新鲜的尸体手臂。通过定制的测试系统,在固定尺骨的同时,向桡骨施加掌侧和背侧的平移力。测试在前臂处于中立位、旋前60°和旋后60°的位置下进行,一次不使用支具,一次使用支具。在每种情况下,测量平移量。然后,将三角纤维软骨复合体(TFCC)从尺骨茎突和尺骨凹处分离,再次进行相同的测试。与完整状态相比,TFCC分离后,在所有前臂旋转中掌侧和背侧平移均显著增加(p<0.05),桡骨旋前位的背侧平移除外(p = 0.091)。无论是在完整标本还是TFCC分离的标本中,使用支具均显著减少了所有前臂旋转中的掌侧和背侧平移(p<0.05),TFCC分离标本中的旋前掌侧和背侧平移除外(分别为p = 0.101和p = 0.131)。使用支具时,TFCC分离的标本在所有前臂旋转中的掌侧或背侧平移与完整标本相比无显著差异(p>0.05)。这种腕部外侧支具改善了正常手腕和TFCC撕裂手腕的DRUJ稳定性,并将TFCC撕裂导致的DRUJ不稳定降低至接近正常水平。