目的探讨极限运动对舟骨-大-小多角骨(Scaphotrapeziotrapezoid,STT)融合体稳定性的影响。方法6具新鲜尸体前臂标本,所有腕关节均先建立舟月骨分离并行STT融合术,在安全活动范围内从0o开始,每5o一个等级,每个等级分别作5万次屈、伸、尺偏和桡偏运动,每次运动前后均摄标准前后位及侧位片,测量舟骨长度、桡舟间距、桡舟角及克氏针松动、弯曲阳性率。所有腕关节均采用运动前后自身对照。结果当屈曲至50o、背伸至35o、桡偏至5o时,极限运动对融合体的稳定性无影响,未出现融合体解体,克氏针弯曲等征象。当屈曲至55o、背伸至40o、桡偏至10o时,融合体的稳定性开始受到影响,此时桡舟角、舟骨长度、桡舟间距及克氏针弯曲阳性率与对照组相比,均有统计学意义(P<0.05)。而尺偏运动过程中,融合体的稳定性始终未受到影响,上述各项指标的变化均无统计学意义(P>0.05)。结论腕关节在掌屈55o、背伸40o、桡偏10o范围以内活动时,融合体的稳定性无影响,但应避免环转运动。

Objective To explore the influence of ultimate activity on the stabilization of Scaphotrapeziotrapezoid (STT)arthrodesis. Method 6 fresh cadaver fore-arm were used to make scapholunatum dissociation (SLD) and STTarthrodesis before ultimate activity (50,000 times/per 5°) simulation. Anterior-posterior view and lateral view were takeneach time before and after the motion. Radialoscaphoid angle(RSA)、radialoscaphoid interval (RSI) and length ofscaphoid were measured and the cinch、bent of the Kirschner Wire were recorded as well. All of the wrists werecompared by self-control in the test. Result Comparing with the control groups, the difference of RSA、RSI、lengthof scaphoid and Bent positive ratio of Kirschner Wire showed statistical significance withthe flexion、extenion、radialand deviation beyond 55°, 40° and 10°, respectively (P<0.05). But, the index mentioned above showed no statisticalsignificance (P>0.05) during whole process of the ulnar deviation. Conclusion It is safe for the wrist within the rangeof motion not beyond flexion 55°、extenion 40°、radial deviation 10°, but circumduction should be avoided.

江苏省“135”工程重点医学人才基金资助(RC2003-101)