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-  2017 

不同术式重建第一腕掌关节稳定性的生物力学研究

DOI: doi:10.7507/1002-1892.201610035

Keywords: 第 1 腕掌关节, 肌腱转位, 韧带重建, 生物力学

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Abstract:

目的 研究不同术式重建第 1 腕掌关节稳定性的生物力学差异,为临床选择重建方式提供理论依据。 方法 以 12 个新鲜成人尸体上肢标本作为研究对象,所有标本均经正侧位X线片检查,排除骨折、骨病、腕部各关节脱位、畸形、退变及关节周围韧带损伤。实验分为 5 组,分别为正常组、损伤组、掌侧重建组、背侧重建组以及掌背侧重建组。随机取 3 个正常标本作为正常组进行生物力学测试后,制备第 1 腕掌关节脱位模型作为损伤组进行测试;剩余 9 个标本随机分为掌侧重建组、背侧重建组以及掌背侧重建组,每组各 3 个标本,制备第 1 腕掌关节脱位模型,分别采用 Eaton-Little 法、尹维田法以及联合两种方法修复重建韧带,并行生物力学测试。记录各组载荷-位移曲线,计算弹性模量并进行统计学分析。 结果 生物力学测试过程中,损伤组和掌侧韧带重建组各 1 例标本出现韧带断裂以及远端 1.5 mm 克氏针滑松,但标本未出现滑脱,其测量结果纳入研究。正常组、损伤组、掌侧重建组、背侧重建组、掌背侧重建组弹性模量分别为(11.61±0.20)、(5.39±0.12)、(6.33±0.10)、(7.12±0.08)、(8.30±0.10)MPa,各组间弹性模量比较差异均有统计学意义(P<0.05)。 结论 掌侧韧带重建、背侧韧带重建及掌背侧韧带重建均能明显提高关节稳定性,其中掌背侧韧带重建效果最好,但仍不能恢复至正常水平

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