Biomechanical study of acromioclavicular and coracoclavicular ligament of acromioclavicular joint stability

肩锁和喙锁韧带对肩锁关节稳定性的生物力学研究

• 批准号: 22K16718
• 负责人: 倉田 慎平
• 金额: $ 2.91万
• 依托单位: Nara Medical University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Early-Career Scientists
• 财政年份: 2022
• 资助国家: 日本
• 起止时间: 2022-04-01 至 2026-03-31
• 项目状态: 未结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-22K16718/
• 关键词: 肩鎖関節脱臼; 烏口鎖骨靭帯; 肩鎖靭帯; 三角筋; 僧帽筋; 生体力学的研究; 菱形靭帯; 円錐靭帯

＜背景＞我々は肩鎖関節脱臼の手術の際に動的安定性を獲得する目的に三角筋と僧帽筋をオーバーラップして修復（Deltoid-trapezius overlap repair，以下DTOR）を行っている．今回の研究の目的は，下方及び水平内転ストレス下において烏口鎖骨靭帯とDTORがそれぞれどのように肩鎖関節の安定性に寄与するかを検討することである．＜方法と対象＞6体の新鮮凍結屍体（男性3肩，女性3肩;平均年齢76.5歳[67-92]）を用いた．創外固定器を用いて検体を実験装置に固定した．3次元磁気センサーを鎖骨遠位，肩峰に挿入し，転位量を測定した．Stage0（intact），Stage1（肩鎖靭帯切離），Stage2（三角筋，僧帽筋切離），Stage3（菱形靭帯切離），Stage4（円錐靭帯切離），Stage5（DTOR）の順にStage分類した．上肢下方牽引時の鎖骨上方転位量，水平内転ストレス時の鎖骨後方転位量を各Stageで測定しStage0との差で評価した．＜結果＞鎖骨上方転位量は，Stage1: 1.5mm，Stage2: 2.2mm，Stage3: 3.7mm，Stage4: 12.1mm，Stage5: 7.15mmであり，Stage3, 4, 5において互いに統計学的有意差を認めた．鎖骨後方転位量は，Stage1: 3.0mm, Stage2: 3.5mm, Stage3: 7.3mm, Stage4: 19.2mm, Stage5: 15.5mmであり，Stage3, 4において互いに統計学的有意差を認めたが，Stage3, 5及びStage4, 5において互いに有意差は認めなかった．＜考察＞上肢下方牽引時に鎖骨の上方制動に寄与することが分かった．肩鎖関節脱臼の治療を行う際には通常の靭帯再建に加え，DTORを行うことで更なる制動を獲得できる可能性が示唆された．

< background > the stability of the dislocation of the shoulder due to the dislocation of the shoulder and the stability of the surgical exercise has been obtained. the purpose of the study is to study the purpose of the study. The purpose of this study is to study the purpose of this study. The purpose of this study is to study the purpose of the study. (background) the purpose of this study is to study the purpose of the study. < background > the stability of the dislocation of the shoulder due to the dislocation of the shoulder and the stability of the surgical movement was obtained. The purpose of the study is to study the purpose of the study. The lower and lower parts of the body are in the middle of the body (3 shoulders for men and 3 shoulders for women). The lower and lower parts of the body are in the lower part of the body, the lower and lower parts of the body, the lower and the lower part of the body, the lower part and the lower part of the body. The average age is 76.5 years [67-92]). The external fixator uses the body to fix the bone position, the acromion is inserted, the position is measured, the stage 0 (intact), the Stage1 (shoulder rib cut off), Stage2 (triangular rib, monk cap cut off), Stage3 (diamond cut off), Stage4 (diamond cut off). Stage5 (DTOR) was used to classify the Stage. The upper position of the upper limb was measured when the upper limb was pulled, and the posterior position of the horizontal internal exercise was measured by each Stage. < results > the measurement of the position above the patella, Stage1: 1.5mm grade 2: 2.2mm stage 3: 3.7mm grade stage 4: 121mm stage 5: 7.15mm stage The intentional difference of Stage3, 4,5-year-old cross-sectional statistics, Stage1: 3.0mm, Stage2: 3.5mm, Stage3: 7.3mm, Stage4: 19.2mm, Stage5: 15.5mm statistics, Stage3, 4-year-old mutual statistics. Stage3, 5 and Stage4, 5 each other intended to contact each other. The upper arm of the upper limb is sent to the upper limb when the upper limb is pulled. The treatment of shoulder dislocation is usually done in the international market, and the DTOR operator is responsible for the possibility of successful operation.