Relative contributions of the ulnar attachments of the triangular fibrocartilage complex to the dynamic stability of the distal radioulnar joint
Relative contributions of the ulnar attachments of the triangular fibrocartilage complex to the dynamic stability of the distal radioulnar joint
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DOI：
10.1016/j.jhsa.2005.11.008
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发表时间：
2006-03-01
影响因子：
1.9
通讯作者：
An, KN
中科院分区：
文献类型：
--
作者：
Haugstvedt, JR;Berger, RA;An, KN
目的：评价远端桡尺关节（DRUJ）稳定结构重要性的实验室研究主要限于静态设计。临床上，动态负荷似乎是DRUJ不稳定的重要组成部分。本研究旨在评估动态载荷对DRUJ中心凹与茎突三角纤维软骨复合体（TFCC）破裂的稳定性的影响。实验室设置。方法：使用动态模拟器测试12个新鲜冷冻尸体上肢标本，以研究TFCC的2个尺骨止点对DRUJ动态稳定性的贡献。在3种不同的TFCC状态（完整、中心凹破坏、茎突破坏）下，分别在3种载荷条件（无载荷、激动剂载荷、拮抗剂载荷）下对标本进行测试。在负载条件下，中央凹插入有更大的影响比茎突插入的稳定性。在激动剂负载显着差异，发现在旋后和旋前运动。与拮抗剂加载一个显着的差异，发现只有在旋后。结论：研究结果支持的临床印象，动态加载是一个重要组成部分的DRUJ不稳定和破坏的中心凹TFCC插入到中心凹区域的远端尺骨可以产生不稳定。
Purpose: Laboratory studies evaluating the importance of the stabilizing structures of the distal radioulnar joint (DRUJ) largely have been limited to static design. Clinically, dynamic loading seems to be an important component of DRUJ instability. This study was designed to evaluate the influence of dynamic loading on the stability of the DRUJ with foveal versus styloid triangular fibrocartilage complex (TFCC) disruptions in a. laboratory setting.Methods: Twelve fresh-frozen cadaveric upper-extremity specimens were tested using a dynamic simulator to study the contributions of the 2 ulnar insertions of the TFCC to the dynamic stability of the DRUJ. The specimens were tested in 3 loading conditions (no load, agonist loading, antagonist loading) in 3 different states of the TFCC (intact, foveal disruption, styloid disruption).Results: Without load no significant differences were found for the different conditions of the TFCC. Under loaded conditions the foveal insertion had a greater effect on stability than did the styloid insertion. Under agonist loading significant differences were found during supinating and pronating motions. With antagonist loading a significant difference was found only during supination.Conclusions: The study results support the clinical impression that dynamic loading is an important component of DRUJ instability and that disruption of the foveal TFCC insertion into the foveal region of the distal ulna can produce instability.