The relationship between the morphological axis and the kinematic axis of the proximal radius
The relationship between the morphological axis and the kinematic axis of the proximal radius
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DOI：
10.1007/s00276-018-2131-0
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发表时间：
2019-04-01
影响因子：
1.4
通讯作者：
Nagura, Takeo
中科院分区：
文献类型：
--
作者：
Oki, Satoshi;Inaba, Naoto;Nagura, Takeo
目的前臂旋转受损的外科手术方法，例如治疗慢性桡骨头脱位，仍然存在争议。我们假设前臂近端的形态轴对于稳定的前臂旋转是重要的，我们的目的是利用四维CT(4DCT)来阐明近端的形态轴和运动轴之间的关系。获得旋后和旋前时优势前臂的四维CT图像。前臂旋转的旋转轴是根据旋后和旋前的所有帧计算的。代表刚体最稳定旋转轴的主惯性轴是通过从近端将其曲面数据增量地扩展1%来计算近端半径的。结果前臂的旋转轴位于尺头中心的径向和后方分别为0.0 mm和0.4 mm，远端为尺头中心凹的径向和掌侧各2.0 mm和1.2 mm。前臂旋转轴(运动轴)与近侧桡骨长度的15.9%处的主轴一致。个体差异很小(SD为1.4%)。结论前臂旋转是以半径近端长度16%处的轴线为基础的。这部分应该对齐的情况下，严重的形态畸形的桡骨小头后，造成嘎吱嘎吱的运动，在复位手术。
PurposeSurgical procedures for impaired forearm rotation such as for chronic radial head dislocation remain controversial. We hypothesized that the morphological axis of the proximal radius is important for stable forearm rotation, and we aimed to clarify the relationship between the morphological axis and the kinematic axis of the proximal radius using four-dimensional computed tomography (4DCT).MethodsTen healthy volunteers were enrolled. Four-dimensional CT of the dominant forearm during supination and pronation was obtained. The rotation axis of forearm rotation was calculated from all frames during supination and pronation. The principle axis of inertia, which represents the most stable rotation axis of a rigid body, was calculated for the proximal radius by extending its surface data incrementally by 1% from the proximal end. The angle between the kinematic rotation axis and the morphological rotation axis of each length was calculated.ResultsThe rotation axis of the forearm was positioned on the radial head 0.0mm radial and 0.4mm posterior to the center of the radial head proximally and 2.0mm radial and 1.2mm volar to the fovea of the ulnar head distally. The principle axis at 15.9% of the length of the proximal radius coincided with the forearm rotation axis (kinematic axis). Individual differences were very small (SD 1.4%).ConclusionForearm rotation was based on the axis at 16% of the length of the proximal radius. This portion should be aligned in cases of severe morphological deformity of the radial head that cause rattling motion of the radial head after reduction procedures.