Iwasaki N, Genda E, Minami A, Kaneda K, Chao E Y
Orthopaedic Biomechanics Laboratory, The Johns Hopkins University, Baltimore, MD 21205-2196, USA.
J Hand Surg Am. 1998 May;23(3):415-24. doi: 10.1016/S0363-5023(05)80459-9.
This study quantifies the changes in force and pressure distributions across the wrist joint in different stages of Kienböck's disease using a 2-dimensional computer simulation model. Twenty-four cases classified as Lichtman's stage II, IIIA, or IIIB (8 cases in each category) were analyzed using the rigid body spring model technique. A 2-dimensional model in the posteroanterior plane of the wrist was loaded through the metacarpals under a total force of 142 N. The joint forces, peak pressures, and ligament tensions calculated on the involved side were normalized against the contralateral normal side values of the same patient. The results demonstrated that significant changes of the force transmission across the wrist joint occurred only from stage IIIA to IIIB, in which scaphoid rotation was prominent. On the basis of this study, scaphoid rotation plays an important role in affecting the wrist joint contact pressure distribution. This may be responsible for the progression of Kienböck's disease.
本研究使用二维计算机模拟模型，对月骨无菌性坏死不同阶段腕关节上的力和压力分布变化进行量化分析。采用刚体弹簧模型技术分析了24例Lichtman分期为II期、IIIA期或IIIB期的病例（各8例）。在腕关节后前平面构建二维模型，通过掌骨施加142 N的总力。将患侧计算得出的关节力、峰值压力和韧带张力，与同一患者对侧正常侧的值进行归一化处理。结果表明，仅在IIIA期到IIIB期，腕关节上的力传递出现显著变化，此阶段舟骨旋转明显。基于本研究，舟骨旋转在影响腕关节接触压力分布方面起重要作用。这可能是月骨无菌性坏死病情进展的原因。
