Mania Sylvano, Zindel Christoph, Götschi Tobias, Carrillo Fabio, Fürnstahl Philipp, Schweizer Andreas
Department of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
Research in Orthopaedic Computer Science Group, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
J Orthop Res. 2023 Apr;41(4):727-736. doi: 10.1002/jor.25428. Epub 2022 Aug 27.
It remains unclear to what extent the interosseous membrane (IOM) is affected through the whole range of motion (ROM) in posttraumatic deformities of the forearm. The purpose of this study is to describe the ligament- and bone-related factors involved in rotational deficit of the forearm. Through three-dimensional (3D) kinematic simulations on one cadaveric forearm, angular deformities of 5° in four directions (flexion, extension, valgus, varus) were produced at two locations of the radius and the ulna (proximal and distal third). The occurrence of bone collision in pronation and the linear length variation of six parts of the IOM through the whole ROM were compared between the 32 types of forearm deformities. Similar patterns could be observed among four groups: 12 types of deformity presented increased bone collision in pronation, 8 presented an improvement of bone collision with an increase of the mean linear lengthening of the IOM in neutral rotation, 6 had an increased linear lengthening of the IOM in supination with nearly unchanged bone collision in pronation and 6 types presented nearly unchanged bone collision in pronation with a shortening of the mean linear length of IOM in supination or neutral rotation. This kinematic analysis provides a better understanding of the ligament- and bone-related factors expected to cause rotational deficit in forearm deformity and may help to refine the surgical indications of patient-specific corrective osteotomy.
目前尚不清楚在前臂创伤后畸形的整个运动范围内，骨间膜（IOM）受影响的程度。本研究的目的是描述与前臂旋转功能障碍相关的韧带和骨骼因素。通过对一具尸体前臂进行三维（3D）运动学模拟，在桡骨和尺骨的两个位置（近端和远端三分之一处）产生四个方向（屈曲、伸展、外翻、内翻）5°的角度畸形。比较了32种前臂畸形类型在旋前时骨碰撞的发生情况以及骨间膜六个部分在整个运动范围内的线性长度变化。四组之间可观察到相似的模式：12种畸形类型在旋前时骨碰撞增加，8种畸形类型在中立旋转时骨碰撞改善，同时骨间膜平均线性长度增加，6种畸形类型在旋后时骨间膜线性长度增加，旋前时骨碰撞几乎不变，6种畸形类型在旋前时骨碰撞几乎不变，旋后或中立旋转时骨间膜平均线性长度缩短。这种运动学分析有助于更好地理解预期会导致前臂畸形旋转功能障碍的韧带和骨骼因素，并可能有助于完善针对特定患者的矫正截骨手术指征。
