Petersen M S, Adams B D
Department of Orthopaedics, University of Arkansas for Medical Sciences, Little Rock.
J Hand Surg Am. 1993 Mar;18(2):328-34. doi: 10.1016/0363-5023(93)90370-I.
Numerous reconstructive procedures have been described for the treatment of chronic instability of the distal radioulnar joint or instability of the stump of the resected distal ulna. This biomechanical study presents an evaluation of the three basic design types that have been used in reconstruction. The initial static stability provided by the reconstructions was tested and compared with the stability of the intact joint. Our findings show that all reconstructive procedures failed to restore natural joint stability. A radioulnar sling design was the most effective of the three types, whereas tenodesis procedures and ulnar collateral ligament reconstruction were much less effective in providing stability. We conclude that current designs have significant biomechanical shortcomings. On the basis of our observations during testing, we believe that improved designs will require an intra-articular reconstruction that more closely duplicates the biomechanical functions of the triangular fibrocartilage complex.
已经描述了许多用于治疗桡尺远侧关节慢性不稳定或切除尺骨远端残端不稳定的重建手术。这项生物力学研究对重建中使用的三种基本设计类型进行了评估。测试了重建提供的初始静态稳定性，并与完整关节的稳定性进行了比较。我们的研究结果表明，所有重建手术都未能恢复自然关节稳定性。桡尺吊带设计是三种类型中最有效的，而肌腱固定术和尺侧副韧带重建在提供稳定性方面效果要差得多。我们得出结论，目前的设计存在重大生物力学缺陷。根据我们在测试过程中的观察，我们认为改进的设计将需要进行关节内重建，更紧密地复制三角纤维软骨复合体的生物力学功能。
