舟月骨间韧带在舟月骨屈伸运动中的作用

目的 研究腕关节屈伸运动时舟月骨间韧带(scapholunate interosseous ligament,SLIL)及其各亚区分级切断后对舟、月骨三维运动的影响,从亚区水平对SLIL在舟、月骨三维运动中的作用进行研究.方法 取12例新鲜冰冻成人上肢标本(左、右侧各6例),分为正常组、断SLIL近侧组、断SIIL近侧+背侧组、断SLIL近侧+掌侧组、SLIL全断组(每组6例),采用三维激光扫描及图像重建技术测定在腕关节屈伸运动时舟、月骨的三维运动数据,并进行统计学分析.结果 正常腕关节在做屈伸运动时,舟月骨的活动方向与腕关节一致,但活动幅度不同,舟骨的活动范围要大于月骨的活动范围.同时,舟月骨还伴有尺桡偏(主要是桡偏)及轻度的旋前旋后活动.切断近侧+掌侧或近侧+背侧亚区组,会对舟月骨的三维运动产生影响.全切断SLIL会导致舟骨掌屈度增加,月骨掌屈活动减弱.结论 采用三维激光扫描及图像重建技术可准确测定腕舟月骨的三维活动度.在SLIL亚区水平上进行的研究表明,部分或全部切断SLIL会对舟月骨的屈伸运动产生明显影响,但SLIL近侧亚区在控制舟月骨运动中不起主要作用.

Role of scapholunate interosseous ligament in flexion-extension motion of scaphoid and lunate

Objective To observe the resection of the scapholunate interosseous ligament (SLIL)and its subregions on the three-dimensional(3-D)movement of the scaphoid and lunate so as to discuss the role of SLIL in the 3D flexion-extension motion of the scaphoid and lunate.Methods Twelve upper extremities(six left extremities and six right extremities)from adult cadaver were used in this study and divided into five groups:normal group,proximal subregion resection group,proximal subregion plus dorsal subregion resection group,proximal subregion plus palmar subregion resection group and whole SLIL resection group.The 3-D laser scan and reconstruction technique were used for meusure ment of the 3-D flexion-extension motion of the scaphoid and lunate.Results In the normal group,the scaphoid and lunate flexed and the radial deviated at the same direction during wrist flexion-extension motion.At the same time,there was minimal scaphoid and lunate pronation-supination during wrist flexionextension.After resection of the proximal and palmar(or dorsal)subregions of the SLIL,some different movements were found compared with the normal specimen.Whole SLIL resection resulted in increase of the flexion motion of the scaphoid but decrease of the palmar flexion of the lunate.Conclusions 3-D laser scanning and image reconstruction techniques can accurately measure the 3D motion of the scaphoid and lunate.Partial or whole resection of SLIL may exert significant effect on the flexion-extension motion of the scaphoid and lunate.However,the proximal subregion of SLIL has no prominent effect on the motion of the scaphoid and lunate.