肘关节外翻稳定性的解剖与生物力学研究

目的探讨影响肘关节外翻稳定性的相关解剖学因素。方法成人上肢尸体标本8侧,解剖观察屈曲-旋前肌群、尺侧副韧带后束、尺侧副韧带前束和桡骨小头解剖特点;另用12侧上肢标本,随机分成两组,两组按不同顺序切断有关的结构,通过特制的生物力学装置,测量两种不同情况下肘关节的外翻稳定性。结果逐级切断各组内侧结构,其外翻角度增加无显著意义(P>0.05)。同时切除桡骨小头,外翻角度达到最大,外翻角度增加有显著意义(P<0.05)。在止点切断尺侧副韧带前束,外翻角度达到最大。桡骨小头切除的同时切断内侧结构尤其是切断尺侧副韧带前束,外翻角度显著增加(P<0.05)。结论肘关节外翻稳定结构主要由桡骨小头和尺侧副韧带来维持,肘关节内侧前臂肌起协同作用。

The Anatomical and Biomechanical Study of Abduction Stability of Elbow hoint

Objective To investigate the relative anatomical structures which influence the abduction stability of elbow joint.Methods Eight adult upper-extremity specimens were included in our study.The anatomical character of flexor-pronator,posterior band of ligamentum collaterale ulnare,anterior band of ligamentum collaterale ulnare,and caput radii were observed.Another 12 specimens were classified into two groups which had different sequence of the above tissues' incision.The biomechanical stability of all 12 specimens were measured by a special instrument.Results The abduction anglesed appear no difference in different sequence of incision,and the maximum was found when the caput radii were cut off.Only the caput radii was cut off while during ulnar structure was cut,the bigger abduction angle could be acquired.The maximum appeared when the anterior band of ligamentum collaterale ulnare was cut.The abduction angles rose up during both cutting off the caput radii and ligamentum collateral ulnare.Conclusion The caput radii and ligamentum collaterale ulnar are the most important structures which keep the abduction stability of elbow,while the ulnare antebrachium muscles have minor effects on elbow abduction stability.As a result,it is important to keep the integrity of caput radii or conduct caput radii replacement surgery when the caput radii frature.At the same time,the ligamentum collaterale ulnar needs to be repaired.