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舟月韧带撕裂后,桡腕关节接触压力未改变。

Radiocarpal Contact Pressures Are Not Altered after Scapholunate Ligament Tears.

作者信息

Huddleston Hailey P, Kurtzman Joey S, Levy Kenneth H, Connors Katherine M, Hayes Westley T, Koehler Steven M

机构信息

Department of Orthopaedic Surgery and Rehabilitation Medicine, State University of New York (SUNY) Downstate Medical Center, Brooklyn, New York.

出版信息

J Wrist Surg. 2021 Jul 14;11(3):250-256. doi: 10.1055/s-0041-1731817. eCollection 2022 Jun.

Abstract

The scapholunate interosseous ligament (SLIL) couples the scaphoid and lunate, preventing motion and instability. Prior studies suggest that damage to the SLIL may significantly alter contact pressures of the radiocarpal joint.  The purpose of this study was to investigate the contact pressure and contact area in the scaphoid and lunate fossae of the radius prior to and after sectioning the SLIL.  Ten cadaveric forearms were dissected distal to 1-cm proximal to the radiocarpal joint and a Tekscan sensor was placed in the radiocarpal joint. The potted specimen was mounted and an axial load of 200 N was applied over 60 seconds.  Sectioning of the SLIL did neither significantly alter mean contact pressure at the lunate fossa (  = 0.842) nor scaphoid fossa (  = 0.760). Peak pressures were similar between both states at the lunate and scaphoid fossae (  = 0.301-0.959). Contact areas were similar at the lunate fossa (  = 0.508) but trended toward an increase in the SLIL sectioned state in the scaphoid fossa (  = 0.055). No significant differences in the distribution of contact pressure (  = 0.799), peak pressure (  = 0.445), and contact area (  = 0.203) between the scaphoid and lunate fossae after sectioning were observed.  Complete sectioning of the SLIL in isolation may not be sufficient to alter the contact pressures of the wrist.  Injury to the secondary stabilizers of the SL joint, in addition to complete sectioning of the SLIL, may be needed to induce altered biomechanics and ultimately degenerative changes of the radiocarpal joint.

摘要

舟月骨间韧带(SLIL)连接舟骨和月骨,防止运动和不稳定。先前的研究表明,SLIL损伤可能会显著改变桡腕关节的接触压力。 本研究的目的是调查切断SLIL前后桡骨舟骨窝和月骨窝的接触压力和接触面积。 对10具尸体前臂在桡腕关节近端1厘米处进行远端解剖,并将Tekscan传感器置于桡腕关节内。将盆栽标本安装好,并在60秒内施加200 N的轴向载荷。 切断SLIL既未显著改变月骨窝处的平均接触压力( = 0.842),也未显著改变舟骨窝处的平均接触压力( = 0.760)。月骨和舟骨窝在两种状态下的峰值压力相似( = 0.301 - 0.959)。月骨窝处的接触面积相似( = 0.508),但在切断SLIL的状态下,舟骨窝处的接触面积有增加趋势( = 0.055)。切断后,舟骨窝和月骨窝之间在接触压力分布( = 0.799)、峰值压力( = 0.445)和接触面积( = 0.203)方面未观察到显著差异。 单独完全切断SLIL可能不足以改变腕关节的接触压力。 除了完全切断SLIL外,可能还需要损伤SL关节的二级稳定结构,以诱发生物力学改变并最终导致桡腕关节退变。

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本文引用的文献

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J Wrist Surg. 2019 Apr;8(2):124-131. doi: 10.1055/s-0038-1676865. Epub 2019 Jan 17.

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