联合肌腱转位手术对肩关节稳定作用的生物力学研究

本文对８具尸体肩关节中联合肌腱（肱二头肌短头和喙肱肌）进行前方稳定性作用的生物力学分析。将上臂置于外展９０°，外旋９０°位，对肱骨头施以１５Ｎ前移力。然后右肩关节囊完整或破损、联合肌腱原位或转位（移位到肩胛下肌和关节囊之间）。对联合肌腱施加０Ｎ、１５Ｎ或３０Ｎ的载荷情况下，通过三维测量仪分别监测肱骨头的位置。结果显示在所有上述情况下随着联合肌腱负载的增加，肱骨头的前移减少。特别是在关节囊破损、联合肌腱转位后，联合肌腱对肱骨头的这种阻挡前移作用最为显著。由此我们认为当上臂处于外展外旋位时，联合肌腱对孟肱关节

BIOMECHANICAL ANALYSIS OF THE CONJOINED TENDON IN THE SHOULDER

The biomechanics of the conjoined tendon(the short head of the biceps and the coracobrachialis muscle) to anterior stability was investigated in 8 cadaver shoulders.Translation tests at 90°abduction and 90°external rotation of the arm were performed by a 1.5 Kg anterior force.The position of the humeral head was monitored by a trimensional tracking device with the conjoined tendon at the original position of transfered under the subscapularis muscle;with 0 Kg,1.5 Kg Or 3 Kg loads applied on the conjoined tendon;and with the capsule intact or damaged by a Bankart lesion.the anterior displacement of the humeral head under 1.5 Kg force was significantly decreased with increasing conjoined tendon loading,especially when the conjoined tendon transfered in the capsular-damaged shoulder.