肘关节内侧副韧带前束损伤的生物力学研究

[目的]研究肘关节内侧副韧带(medial collateral-ligament,MCL)前束的生物力学作用,探讨肘关节内侧不稳定的发生机制。[方法]将人体肘关节尸体标本按照前束的完整程度分为3组:完整组、部分切断组、完全切断组,测量肘关节在不同屈曲角度下及不同程度前束损伤后关节松弛度(关节在极限以内的力或扭矩作用下的活动量或旋转[1])、肱尺关节平均压强和关节接触面积。[结果](1)前束完整组内外翻松弛度及全部切断组内平均压强和关节接触面积比较无统计学差异(P>0.05);(2)部分切断组及完全切断组外翻松弛度组内比较有统计学差异(P<0.05);前束完整组及前束部分切断组平均压强及接触面积组内比较均有统计学差异(P<0.05);(3)三组在关节松弛度、肱尺关节平均压强和关节接触面积的组间比较均存有统计学差异(P<0.05)。[结论](1)前束是肘关节内侧稳定的主要结构;(2)关节松弛度与关节内压强呈正相关关系,与关节接触面积呈负相关关系;(3)肘外翻应力试验应在屈肘>30°时进行,如外翻松弛度接近10°考虑MCL前束不完全断裂;如外翻松弛度达15°左右考虑MCL前束完全断裂;(4)前束部分损伤时是治疗肘内侧不稳的关键时期。

The biomechanics research of anterior bundle in MCL injury of elbow joint

[Objective]To investigate the biomechanics effect of anterior bundle in medial collateral-ligament(MCL) and approach the mechanism of interior in elbow joint instability.[Method]The elbow joint specimen were divided into 3 groups according to the complete degrees of anterior bundle in MCL(complete anterior bundle group,partly cutting off group and absolutely cutting off group).The joint laxitas-degree(the activity amount or revolving of the joint under the effect of the power less than limit or torque),the average pressure in humeroulnar joint and the joint touch area under different flex degree of elbow joint and different injury degree of anterior bundle in MCL were measured.[Result]1.The laxitas-degree in complete anterior bundle group and the average pressure and the touch area in absolutely cutting off group had no statistics difference(P>0.05).2.The laxitas-degree in the group both in partly cutting off group and absolutely cutting off group had statistics difference(P<0.05).The average pressure and the touch area in the group both in complete anterior bundle group and partly cutting off group had statistics difference(P<0.05).3.The laxitas-degree,average pressure and the touch area among the 3 groups had statistics difference(P<0.05).[Conclusion]1.The anterior bundle is the important structure for keeping the stability of elbow joint.2.The joint laxitas-degree has positive correlation whith average pressure in humeroulnar joint and has negative correlation whith touch area.3.The elbow joint check should be in the condition of the flex degree more than 30°,it could avoid the effect of elbow joint static stable system for the checking result,the laxitas-degree was 10° mean the anterior bundle ruptured partly,the laxitas-degree was 15° mean the anterior bundle ruptured completely.4.The timepoint of the anterior bundle broken partly is the key period to treat the interior in elbow joint instability.