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使用腕部外固定带支具稳定桡尺远侧关节伴或不伴三角纤维软骨复合体撕裂:一项尸体研究

Stabilization of the Distal Radioulnar Joint with or without Triangular Fibrocartilage Complex Tear by an External Wrist Band Brace: A Cadaveric Study.

作者信息

Shin Seung-Han, Park Taeyong, Hong Eunah, Kwak Dai-Soon, Chung Yang-Guk

机构信息

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.

出版信息

Healthcare (Basel). 2022 Apr 30;10(5):828. doi: 10.3390/healthcare10050828.

DOI:10.3390/healthcare10050828
PMID:35627965
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9142000/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9117/9142000/7494681810da/healthcare-10-00828-g003a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9117/9142000/ee4137e5e39d/healthcare-10-00828-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9117/9142000/fc8cc5118a58/healthcare-10-00828-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9117/9142000/7494681810da/healthcare-10-00828-g003a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9117/9142000/ee4137e5e39d/healthcare-10-00828-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9117/9142000/fc8cc5118a58/healthcare-10-00828-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9117/9142000/7494681810da/healthcare-10-00828-g003a.jpg

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本文引用的文献

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Management of Acute Distal Radioulnar Joint Instability Following a Distal Radius Fracture: A Systematic Review and Meta-Analysis.桡骨远端骨折后急性下尺桡关节不稳定的治疗:一项系统评价和荟萃分析
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TFCC injuries: How we treat?三角纤维软骨复合体损伤:我们如何治疗?
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桡尺远侧关节不稳:当前的治疗理念
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Conservative Treatment Is Sufficient for Acute Distal Radioulnar Joint Instability With Distal Radius Fracture.保守治疗对伴有桡骨远端骨折的急性下尺桡关节不稳足够有效。
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