Kang H J, Lee S G, Phillips C S, Mass D P
Department of Surgery, University of Chicago, IL 60637, USA.
J Hand Surg Am. 1996 Nov;21(6):963-8. doi: 10.1016/S0363-5023(96)80300-5.
This study was designed to investigate whether the position of the wrist or sectioning of the transverse carpal ligament (TCL), as well as the palmar fascia and forearm fascia, modifies the biomechanical behavior of the finger flexion, as defined by changes of excursion, load (force), and work of the flexor tendons. The parameters were measured in fresh-frozen cadaver hands with the wrist in 30 degree extension, neutral, and 30 degree flexion, before and after division of the TCL. Having the wrist in extension improved excursion efficiency, whereas flexing the wrist produced the opposite effect, with a 16% decrease in excursion efficiency after division of the TCL. Change in excursion efficiency between the intact and cut TCL was 8% in the flexed position, 5% in the neutral position, and 0.3% in the extended position. Change in load efficiency between intact and cut TCL was 11% in the flexed position, 6% in the neutral position, and 0% in the extended position. Change in the work efficiency between intact and cut TCL groups was noted most with the wrist in the flexed position (13%), compared to a small change (3%) in neutral wrist position and no change in wrist extension. A significant decrease in the excursion efficiency of the flexor tendons was demonstrated when the wrist was in the flexed position. Any increase in the excursion of the flexor tendons could clinically result in decreased grip strength when the wrist is flexed. Furthermore, the effects of TCL division were not significant when wrist position was in extension.
本研究旨在调查手腕位置或横腕韧带（TCL）以及掌腱膜和前臂筋膜的切断，是否会如屈肌腱的移动、负荷（力）和功的变化所定义的那样，改变手指屈曲的生物力学行为。在切断TCL之前和之后，于新鲜冷冻的尸体手上测量这些参数，手腕分别处于30度伸展、中立和30度屈曲位置。手腕伸展时可提高移动效率，而手腕屈曲则产生相反效果，切断TCL后移动效率降低16%。在屈曲位置，完整TCL与切断TCL之间的移动效率变化为8%，中立位置为5%，伸展位置为0.3%。完整TCL与切断TCL之间的负荷效率变化在屈曲位置为11%，中立位置为6%，伸展位置为0%。完整TCL组与切断TCL组之间的功效率变化在手腕屈曲位置最为明显（13%），相比之下，手腕中立位置变化较小（3%），手腕伸展时无变化。当手腕处于屈曲位置时，屈肌腱的移动效率显著降低。临床上，当手腕屈曲时，屈肌腱移动的任何增加都可能导致握力下降。此外，当手腕处于伸展位置时，切断TCL的影响并不显著。
