Abstract

目的 探讨部分腕骨融合术后腕关节的活动范围、压力负荷及对腕关节生理状态的影响.方法选用12例新鲜腕关节标本随机分为3组,A组:舟大小融合术;B组:舟骨三角骨切除+头月融合术;C组:四角融合+舟骨切除术.通过CSS-44020系列生物力学试验机,用100 N力,以5mm/s的速度分别牵引腕关节被动掌屈、背伸、尺偏和桡偏,并测量A、B、C 3组标本的活动角度.然后,于腕关节内放置压敏片,用自制的实验架将腕关节固定于中立位,以5 N/s的压速对腕关节施压至200 N,维持60 s后测量压敏片上各组标本的受力面积和压力负荷.结果 (1) 活动范围:A组掌屈(68.4±5.2)°(±s,下同)、背伸(51.5±4.6)°、尺偏(24.5±2.3)°、桡偏(15.7±3.4)°.B组掌屈(64.5±7.1)°、背伸(60.0±5.2)°、尺偏(42.4±3.2)°、桡偏(26.9±5.2)°.C组掌屈(61.9±6.6)°、背伸(54.9±5.3)°、尺偏(27.1±3.9)°、桡偏(17.0±4.9)°.(2) 腕关节的受力面积:A组为(265.00±8.97)mm2.B组为(125.81±5.97)mm2.C组为(164.00±8.43)mm2.(3) 负荷压力:A组为(53.87±3.07)N/cm2.B组为(112.86±0.74)N/cm2.C组为(55.28±5.11)N/cm2.结论舟大小融合术、舟骨切除+四角融合术对腕关节应力负荷的影响与正常腕关节相比变化不大,而舟三角骨切除+头月融合术对腕关节的影响较大,其应力负荷的增加明显超出了正常腕关节所承受的压力负荷。

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