Valgus stability of the elbow. A definition of primary and secondary constraints.
Valgus stability of the elbow. A definition of primary and secondary constraints.
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DOI：
10.1097/00003086-199104000-00021
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发表时间：
1991-04
影响因子：
4.2
通讯作者：
B. Morrey;Shinji Tanaka;K. An
中科院分区：
文献类型：
--
作者：
B. Morrey;Shinji Tanaka;K. An
在模拟主动运动和肌肉活动的模型上，用跟踪装置研究了手肘关节抵抗外翻应力的稳定结构。通过改变内侧副韧带复合体的连续释放和桡骨头的移除的顺序，确定每个结构对克服重力作用的外翻稳定性的贡献。在其他完整的肘关节中，桡骨头的缺失不会显著改变肘关节运动的三维特征。另一方面，单独的内侧副韧带松解会导致外展旋转增加约6度-8度。松解这两个结构会导致明显的外展松弛和肘关节半脱位。本研究将内侧副韧带（MCL）定义为手肘关节对外翻应力的主要约束，桡骨头定义为次要约束。这一定义有助于桡骨头骨折和MCL中断患者的正确治疗。不合并内侧副韧带功能不全的粉碎性桡骨头骨折应切除治疗，不需要植入物，也不需要担心改变手肘的正常运动学。
The stabilizing structures of the elbow that resist valgus stress were studied with a tracking device in a model simulating active motion and muscle activity. By varying the order of serial release of the medial collateral ligament complex and removal of the radial head, each structure's contribution to valgus stability against the effect of gravity was determined. In the otherwise intact elbow, absence of the radial head does not significantly alter the three-dimensional characteristics of motion in the elbow joint. Isolated medial collateral release, on the other hand, causes increases in abduction rotation of about 6 degrees-8 degrees in magnitude. Releasing both structures results in gross abduction laxity and elbow subluxation. This study defines the medial collateral ligament (MCL) as the primary constraint of the elbow joint to valgus stress and the radial head as a secondary constraint. This definition facilitates the proper management of patients with radial head fractures and MCL disruption. The comminuted radial head fracture uncomplicated by MCL insufficiency should be treated by excision without the need for an implant and without concern of altering the normal kinematics of the elbow.