应用动态双平面成像技术研究在体肘关节主动屈伸运动特征
DOI:
作者:
作者单位:

1.上海交通大学,生物医学工程学院,上海,中国;2.上海市第六人民医院,骨与关节生物力学实验室,上海,中国;3.上海交通大学医学院附属第九人民医院,骨科,上海,中国

作者简介:

通讯作者:

中图分类号:

基金项目:

国家自然科学基金项目(面上项目,重点项目,重大项目)


In-Vivo Kinematic Characteristics of the Elbow during Active Flexion-Extension Motion Using Dual Fluoroscopic Imaging System
Author:
Affiliation:

1.School of Biomedical Engineering &2.Med-X Research Institute, Shanghai Jiao Tong University;3.Department of Orthopaedic Surgery and Orthopaedic Biomechanical Laboratory, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine;4.Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine;5.School of Biomedical Engineering, Shanghai Jiao Tong University

Fund Project:

The National Natural Science Foundation of China (General Program, Key Program, Major Research Plan)

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    [目的] 探讨健康肘关节屈伸运动时,关节的相对位移和旋转角度变化以及其间的关系,理解健康肘关节运动模式,为肘关节不稳以及严重肘关节损伤的治疗提供参考。[方法] 选取10名健康并且无上肢外伤史的受试者。应用双平面动态X光摄影技术,测量右侧肘关节从旋后最大伸直位至旋后最大屈曲位运动过程中,肱桡与肱尺关节六自由度运动学数据。使用相关性分析肘关节不同自由度运动的耦合度。[结果] 在正常肘关节屈伸运动中,从最大伸直位到最大屈曲位,肱尺关节外翻角从15.2°±3.1° 降低到5.3°±2.3°,肱桡关节外翻角从19.7°±4.2°减小到8.2°±2.4°, 肱尺与肱桡关节外翻角与屈曲角呈线性相关(R2=0.98, p<0.0001,R2=0.989, p<0.0001);肱尺关节内外旋角随屈曲角先内旋后外旋,呈二次非线性相关( R2=0.93 p<0.0001),内旋角在屈曲110°时达到最大值4.0°±4.9°,后达到最大外旋值5.1°±4.2°。肱桡关节一直呈现内旋增大变化,从内旋3.2°±16.0°增加到内旋27.2°±18.0°。[结论] 正常肘关节的屈伸过程中,肱尺关节存在外翻角度线性减小以及内外旋角度先内旋后外旋的非线性变化,肱桡关节存在外翻角线性减小,内旋角度线性增大的变化。在屈伸过程中,肘关节并非单纯铰链关节,并且肱尺关节与肱桡关节存在运动学差异。临床上治疗复杂肘关节损伤、肘关节不稳以及肘关节置换手术时,应考虑关节间不同运动特征,以提高术后临床效果。

    Abstract:

    [Objective] This study aimed to investigate the translation and rotation of healthy elbow joints during active flexion and extension, to understand the kinematic characteristics of the healthy elbow joint, and to provide baseline data for the treatment of elbow instability and injury. [Methods] Ten healthy subjects with no history of upper extremity trauma were recruited. We applied dual fluoroscopic tracking technique to quantify six-degree-of-freedom (6-DOF) kinematics of humeroulnar and humeroradial joint from full extension to maximum flexion in supination position. Correlation analysis was used to evaluate the relationship between the 6-DOF kinematics of the elbow joint. [Results] During the elbow active flexion and extension motion, valgus angle of humeroulnar joint gradually decreased from 15.2°±3.1° to 5.3°±2.3°while the flexion increasing. valgus angle of humeroradical joint gradually decreased from 19.7°±4.2° to 8.2°±2.4° from full extension to maximum flexion. The valgus angle of humeroulnar and humeroradial joint are linearly related to the flexion angle during the flexion and extension motion (R2=0.98, p<0.0001, R2=0.989, p<0.0001). The internal rotation of humeroulnar joint is quadratic nonlinearly related to the flexion angle during motion (R2=0.93, p<0.0001). The maximum internal rotation of the ulnar was 4.0°±4.9° at 110° flexion, and the maximum externally rotation was 5.1°±4.2° as follow. The internal rotation of humeroulnar joint is gradually increased from 3.2°±16.0° to 27.2°±18.0°. [Conclusions] Humeroulnar joint decreases linearly at valgus change, it shows nonlinearly change which rotate internally firstly and then rotate externally during flexion. The valgus angle of humeroradial joint decrease linearly and internal rotation angle increase linearly. Therefore, humeroulnar joint is not a hinge joint during flexion. Kinematic is difference between humeroulnar and humeroracial joint. The current study provided insights into clinical treatment of complex elbow injuries, elbow instability, and development of new elbow prosthesis.

    参考文献
    相似文献
    引证文献
引用本文
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2019-10-09
  • 最后修改日期:2019-11-25
  • 录用日期:2019-12-03
  • 在线发布日期:
  • 出版日期: