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模拟Bankart损伤的生物力学评估

Biomechanical evaluation of a simulated Bankart lesion.

作者信息

Speer K P, Deng X, Borrero S, Torzilli P A, Altchek D A, Warren R F

机构信息

Laboratory for Soft Tissue Research, Hospital for Special Surgery, New York City, N.Y. 10021.

出版信息

J Bone Joint Surg Am. 1994 Dec;76(12):1819-26. doi: 10.2106/00004623-199412000-00008.

DOI:10.2106/00004623-199412000-00008
PMID:7989387
Abstract

The purpose of this study was to determine the effect of sectioning of the anterior part of the inferior glenohumeral ligament (a simulated Bankart lesion) on load-induced multidirectional glenohumeral motion. Nine fresh, intact cadaveric shoulders were tested on a special apparatus that constrained three rotations but allowed simultaneous measurement of anterior-posterior, superior-inferior, and medial-lateral translation. Coupled anterior-posterior and superior-posterior translations were recorded while anterior, posterior, superior, and inferior forces of fifty newtons were applied sequentially. Testing was done in three positions of humeral elevation in the scapular plane, in three positions of humeral rotation, and with an externally applied joint-compression load of twenty-two newtons. A liquid-metal strain-gauge was placed on the posterior band of the inferior glenohumeral ligament to assess concomitant posterior capsular strain during the various test conditions. All shoulders were tested intact and again after the inferior glenohumeral ligament and the labrum had been detached from the glenoid from just superior to the anterior band of the inferior glenohumeral ligament to a point just posterior to the infraglenoid tubercle. The simulated Bankart lesion resulted in selected increases in anterior translation at all positions of elevation, in posterior translation at 90 degrees of elevation, and in inferior translation at all positions of elevation. However, these increases were very small; the maximum mean increase in translation seen over-all was only 3.4 millimeters, which occurred during inferior translation at 45 degrees of elevation.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本研究的目的是确定切断下盂肱韧带前部(模拟Bankart损伤)对负荷诱导的多方向盂肱关节运动的影响。在一个特殊装置上对九个新鲜、完整的尸体肩部进行测试,该装置限制了三个旋转方向,但允许同时测量前后、上下和内外平移。在依次施加50牛顿的前、后、上和下力时,记录耦合的前后和上后平移。测试在肩胛平面内肱骨抬高的三个位置、肱骨旋转的三个位置以及施加22牛顿的外部关节压缩负荷的情况下进行。在下盂肱韧带的后束上放置一个液态金属应变计,以评估在各种测试条件下伴随的后关节囊应变。所有肩部在完整状态下进行测试,然后在下盂肱韧带和盂唇从盂肱韧带前束上方至肩胛下结节后方一点处从关节盂分离后再次进行测试。模拟的Bankart损伤导致在所有抬高位置的前向平移、90度抬高时的后向平移以及所有抬高位置的下向平移均有特定增加。然而,这些增加非常小;总体上观察到的最大平均平移增加仅为3.4毫米,这发生在45度抬高时的下向平移过程中。(摘要截短至250字)

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