【作者】 黄继锋； 徐永年； 赵卫东； 樊继宏； 钟世镇；

【Author】 HUANG Jifeng, XU Yongnian, ZHAO Weidong et al. Department of Orthopaedics Wuhan General Hospital of Guangzhou Command Wuhan 430070, China

【机构】 广州军区武汉总医院骨科；

【摘要】 目的:研究三角纤维软骨复合体(triangular fibrocartilage complex,TFCC)水平部分结构切除的几种术式对尺骨载荷功能的影响,从生物力学的角度分析手术的疗效及机制。方法:采用8侧青年新鲜尸体上肢标本,固定在加载架上用MTS试验机控制加载,采用压敏片测量压力,分析TFCC水平部分不同程度切除后对尺侧腕传递载荷功能的影响。结果:TFCC水平部分1／3切除后,腕部传递至尺骨的载荷稍减小,与完整标本相比,差异无显著性意义(t=2．1, P>0．05);2／3切除或全部切除后腕部传递至尺骨的载荷明显减小,与完整标本相比,差异有显著性意义(t=3．4,P<0．05,t=7．2,P<0．01)。结论:TFCC水平部分具有传递载荷的功能,其不同程度的切除可导致腕关节传递至尺骨轴向载荷的大小发生改变。更多还原

【Abstract】 Objective To evaluate the effect of the several operative procedures of gradual excision of the horizontal portion of the triangular fibrocartilage complex TFCC on ulnar support of the carpus and the therapeutic mechanisms of these operations. Methods Eight upper extremities specimens were taken from fresh young adult cadavers and were mounted in a loading frame. During these experiments 100 N axial load controlled by MTS universal testing machine was applied across the wrist joint at each position and the force through ulna was measured by means of pressure sensitive film and the calculation of the computer. Results Removal of one third of the horizontal portion of the TFCC was found to have no marked effect on the forearm axial load transmission t=2.1, P >0.05. Removal of two thirds or the entire horizontal portion of the TFCC caused a statistically significant difference in the percentage of force transmitted through the ulna com-pared with the intact force data t=3.4, P< 0.05, t=7.2,P< 0.01. Conclusion The horizontal portion of the TFCC functions as a cushion for the ulnar carpus carrying approximately 20% of the axial load of the forearm in a cadaver specimen. The gradual excision of the horizontal portion of the TFCC unloaded the ulna noticeably.更多还原