Savelberg[22](1991)对腕关节运动时部分掌侧和背侧韧带的长度变化做过研究。掌侧桡舟头韧带和背侧桡三角韧带,屈腕时的最大长度变化较尺 桡偏时大。最大桡偏时较中立位没有韧带明显伸长。最大尺偏时,桡舟头韧带、桡月韧带、三角头韧带的近侧部分和背侧腕关节韧带较中立位时明显伸长。最大背伸时,桡舟头韧带、桡月韧带的远侧部分和三角头韧带的近侧部分伸长明显,背侧腕关节韧带明显缩短。最大屈腕时,只有背侧腕关节韧带轻度伸长,其余韧带无明显伸长,桡舟头韧带、桡月韧带和三角头韧带明显缩短。掌侧月三角韧带,无论手腕做任何运动,其长度都没有明显变化。同时还注意到宽韧带的近、远两侧的长度变化是不同的。如尺偏时,桡月韧带的远侧伸长,而近侧部分无变化;三角头韧带的远侧部分 缩短,而近侧部分无变化。背伸时,三角头韧带的近侧部分伸长,而远侧部分无变化。
Crison[23](1997)在活体上研究了锻炼活动对腕关节韧带刚度的影响,发现手腕的锻炼活动可以明显降低腕关节韧带的刚度,腕骨的位移活动度增加。休息1h后,腕关节韧带的刚度部分恢复到活动前的水平。24h后与活动前一样。说明了锻炼活动腕关节,可以降低腕关节韧带的刚度,增加了腕关节的松弛度,可以减少运动引起的损伤。
腕关节韧带损伤后引起的腕关节不稳定,如舟月骨间分离,月三角骨不稳定等,治疗的方法很多,但效果有时不能肯定。最近Shin[24](1988)比较了舟月骨间韧带背侧部分与Lister结节处的第3伸肌支持韧带的生物力学特性和组织学特性,虽然第3伸肌支持韧带的断裂强度较舟月骨间韧带的背侧部分小许多,但单位面积上的断裂强度两者相差不大,两者的组织学特性相近。Weiss[25](1988)在临床上用两端带桡骨的第3伸肌支持韧带移植治疗舟月骨间分离19例病人,其中14例动力型舟月骨间分离,12例疼痛消失,2例腕关节重体力活动时疼痛;而 5例静力型舟月骨间分离,2例疼痛消失,1例腕关节重体力活动时疼痛,2例仍持续疼痛。作者认为用两端带桡骨的第3伸肌支持韧带移植治疗动力型舟月骨间分离的效果是可以的,而治疗静力型舟月骨间分离的效果差,其原因是第3伸肌支持韧带的强度不够。能否找到两端带骨,切取方便,韧带强度与腕部断裂韧带相近的更好供区,需要进一步研究。
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