Soft-tissue stabilizers of the distal radioulnar joint:: An in vitro kinematic study
Soft-tissue stabilizers of the distal radioulnar joint:: An in vitro kinematic study
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DOI：
10.1016/j.jhsa.2004.01.020
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发表时间：
2004-05-01
影响因子：
1.9
通讯作者：
King, GJW
中科院分区：
文献类型：
--
作者：
Gofton, WT;Gordon, KD;King, GJW
目的：远端桡尺关节（DRUJ）的稳定性取决于骨性解剖结构、软组织稳定器和肌肉活动。DRUJ软组织固定器的相对重要性仍然存在争议，并且尚未在完整标本中模拟肌肉负荷的生理环境中进行检查。本研究的目的是探讨静态稳定剂的作用，在积极的模拟motion.Methods的运动学的DRUJ：12具尸体上肢进行计算机控制的，模拟的，积极的前臂旋转。在完整标本中和连续切片软组织稳定器后测量关节运动学，包括背侧和掌侧桡尺韧带（RUL）和三角纤维软骨（TFC），背侧和掌侧囊，尺腕韧带（UCL），尺侧腕伸肌（ECU）下鞘，旋前方肌（PQ）和骨间膜（IOM）。在软组织切片后，观察DRUJ的显著变化，运动学I。与远侧到近侧的切片序列的运动学显着改变，直到切片的IOM没有确定;与近侧到远侧的切片序列完整的DRUJ运动学保持，直到最后的软组织（RULs和TFC）sectioning.Conclusions：切片的所有软组织稳定剂产生显着的DRUJ不稳定和异常关节运动学。RUL和TFC在DRUJ运动学中起着关键作用，因为它们可以在没有所有其他软组织稳定器的情况下帮助维持正常的关节旋转。然而，在保留其他软组织稳定器的情况下，RUL和TFC对于维持DRUJ的正常运动学不是必需的。美国手外科学会版权所有（C）2004。
Purpose: Distal radioulnar joint (DRUJ), stability is dependent on osseous anatomy, soft-tissue stabilizers, and muscle activity. The relative importance of DRUJ soft-tissue stabilizers remains controversial and has not been examined in the more physiologic setting of simulated muscle loading in the, intact specimen. The purpose of this study was to examine the role of static stabilizers on the kinematics of the DRUJ during active simulated motion.Methods: Twelve cadaveric upper extremities underwent computer-controlled, simulated, active forearm rotation. joint kinematics were measured in the intact specimen and after sequential sectioning of soft-tissue stabilizers including the dorsal and palmar radioulnar ligaments (RULs) and the triangular fibrocartilage (TFC), dorsal and palmar capsule, ulnocarpal ligaments (UCL), extensor carpi ulnaris (ECU) subsheath, pronator quadratus (PQ), and the interosseous membrane (IOM).Results: After sectioning of soft tissues significant changes in the DRUJ, kinematics I were ob served. With a distal to proximal sectioning sequence significant alterations in kinematics were not identified until sectioning of the IOM; with a proximal to distal sectioning sequence intact DRUJ kinematics were maintained until the final soft-tissue (RULs and TFC) sectioning.Conclusions: Sectioning of all soft-tissue stabilizers produced significant DRUJ instability and abnormal joint kinematics. The RULs and TFC play a key role in DRUJ,kinematics because they can help to maintain normal joint rotation in the absence of all other soft-tissue stabilizers. With the preservation of other soft-tissue stabilizers, however, the RULs and TFC are not essential for the maintenance of normal kinematics of the DRUJ. Copyright (C) 2004 by the American Society for Surgery of the Hand.