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 Wysłany: Sob 14:30, 23 Kwi 2011 Temat postu: Christian Louboutin Greece vxh gdq ywmu mvu |
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Ligament anatomy and biomechanical properties of Research
Carpal ligament is a highly differentiated system of complex connections, not only has the limit excessive activity, stability, the role of the wrist, but also transfer stress to coordinate the function of wrist movement. In recent years,[link widoczny dla zalogowanych], instability of wrist joint has been gradually recognized by clinicians, on the wrist ligament anatomy and function of research attention. Previous studies on the beginning and ending wrist ligaments, course, and there are many naming inconsistencies. Carpal ligaments in recent years now and biomechanical studies of anatomical progress are summarized below. 1 volar wrist ligaments Chinese papers League finishing. 1.1 radiocarpal ligament and the ulnar carpal ligament (1) boat radial ligament (radioscaphoid ligament), called the past, some of the radial collateral ligament [1], but it is not located side of the wrist, but tend to palm side of the axis of its dorsal flexion and extension joint walk through, it is not true in the anatomy of the lateral collateral ligament. Therefore, at present most of the scholars called for the radial boat ligament [2,3]. Mayfield reported fracture strength of the radial ligament boat average 70N [4]. (2) radial head boat ligament (radioscaphcapitate ligament), it was also called radial head ligament (radiocapitate ligament). The average breaking strength of 170N [4]. (3) radial ligament (radiolunate ligament), some scholars have called a long radial ligament (long radiolunate ligament) [5], the ligament is more robust, is to stabilize the ligaments on one of the important bone, the fracture strength of the average 210N [4]. Mayfield on the radial ligament and the ligament that is a triangular ligament, and called radial triangular ligament. At present, many authors have confirmed that the ligament is actually two ligaments, as have their own starting and ending points. (4) radial scapholunate ligament (radioscapholunate ligament), Mayfield boat called radial ligament (radioscaphoid ligament). Most of its dead end in the palm of proximal scaphoid, a small part of the bone ends on the radial side of the edge of the palm,[link widoczny dla zalogowanych], so called radial scapholunate ligament is more precise. Some authors believe that the radial scapholunate ligament in stabilizing the proximal carpal row, especially the navicular bone has an important role in near-polar [6 ~ 8]. But Berger [9] and Hixson [10] The study confirmed that it is mainly from the anterior interosseous artery, radial artery and the anterior interosseous nerve composed of neurovascular bundles, peripheral lined with synovial tissue,[link widoczny dla zalogowanych], collagen fibers few, no elastic fibers . Its structure was different from other ligaments, and that it does not belong to the real ligament structure. But it may be 54N. Our study found that radial scapholunate ligament mainly composed of loose connective tissue, blood vessels during rich, but very few collagen fiber bundles, such as the results are consistent with Berger. (5) foot ligament (ulnolunate ligament), but also scholars called for a short radial ligament (short radiolunate ligament). Our research found that this ligament is healthy, and is stable on the important structure of bone, the fracture strength of the average 219.2N. (6) foot triangular ligament (ulnotriguetrum ligament), we found that this ligament is relatively weak, the average breaking strength of 54N. (7) the ulnar wrist capsule tuberculosis, there are some scholars called for the ulnar collateral ligament (ulnar collateral ligament). But TalEisnik [11] and in wins Kyrgyzstan [2] found that it is not true ligament, but the joint capsule thickening, saying that it is the ulnar capsule structure. We study the average breaking strength of 58.7N. 1.2 between carpal ligament. (1) January triangular ligament, starting on bone surface, beyond the palm triangular bone, triangular bone below it for a month between the ligaments. January February triangular triangular ligament and volar interosseous ligament is difficult to separate the parts. (2) triangular hamate ligament, located in the proximal edge of the palm of hamate and triquetrum between the distal end. This ligament is stronger, and radial deviation of wrist dorsiflexion when the tension, ulnar deviation and palmar Qushi Song relaxation [12]. (3) the first boat the size of polygon-shaped bone ligament, there are scholars called for the boat most of the angular bone ligament complex (scaphotrapezial ligament complex). Drewniany [13] that it is the 4 parts: ① in the scaphoid bone and joint most of the palmar angle, radial side of the tough ligaments, the palmar part of the flexor carpi radialis tendon sheath and connected, and only to the trapezoid fibers ; ② weak palmar joint capsule; ③ boat head ligament; ④ weak dorsal joint capsule. Most of the scaphoid bone and joint volar angle, radial collateral ligament robust, easy to break, under the action of the violent and prone to fracture the attachment points, such as the scaphoid tubercle fracture. Boat size of the polygonal head of bone distal ligament is an important stabilizing structure of the boat. (4) triangular ligament,[link widoczny dla zalogowanych], also known as radial ligament, the ligament in the first boat, the first month and triangular ligaments constitute the first tendon. Boat boat the size of the first ligament has been described in the trapezoid ligament: ligament is often absent on head, causing the skull on the lack of direct inter-articular ligament contact; triangular head ligament, since the triangular bone from the radial side of palm and a half, across the proximal hamate , limited to the first palm-shaped bone body. 2 dorsal carpal ligament volar carpal ligament dorsal ligaments than a small number, and the weak. Are: (1) triangular dorsal radioulnar ligament, scholars called the dorsal radiocarpal ligaments (dorsal radiocarpal ligament), the thick tough ligaments, the average breaking strength of 240N. (2) triangular dorsal radial ligament, this ligament is sometimes absent. (3) between the dorsal carpal ligament, the relatively small weak. 3 the inner wrist ligaments 3.1 within the proximal row carpal ligament a scapholunate interosseous ligament and the monthly Triangle interosseous ligament. (1), scapholunate interosseous ligament connecting the scaphoid and lunate, Berger [14] (1996) reported a detailed gross and histological findings, the scapholunate interosseous ligament in anatomy is divided into three parts, namely the back side of the proximal and palmar parts. Dorsal part of the thick, arranged by the short transverse collagen fibers. Mainly by the proximal part of the cartilage and a small superficial longitudinal fibers arranged collagen fibers, the proximal part of the same as the knee meniscus, can suddenly scapholunate joint space to a few millimeters. Radial scapholunate ligament scapholunate interosseous ligament and the proximal part of the volar part of the separation. Palmar part of the book,[link widoczny dla zalogowanych], arranged by the oblique form of collagen fiber bundles. Scapholunate ligament rupture strength between the average 260N [15]. It is to maintain the scaphoid bone near-polar and scapholunate joint stability and motion coordination between important structures. Short [16] and other study found that cutting the scapholunate interosseous ligament, causing scaphoid flexion, pronation and lunate dorsiflexion change. Boabighi [17] the scapholunate interosseous ligament and the size of the boat-shaped bone ligament polygonal head comparison, the former for the latter breaking strength of 1 / 2. (2) months triangular ligament between the bones, we found that between January triangular bone and ligament anatomy and histological features similar to the scapholunate interosseous ligament, the anatomy is also divided into three parts, namely dorsal, proximal and palmar part. Mainly by the proximal part of the cartilage and a small superficial longitudinal fibers arranged collagen fibers, but dense some. The average fracture strength 375.3N, compared with the scapholunate interosseous ligament large. 3.2 within the distal row carpal ligament Ritt [18] (1996) reported the first details of the general hook ligament and histological findings. Found that the first hook joint between the existence of three kinds of bone ligament, dorsal, and deep palmar interosseous ligament, which favor the deep volar interosseous ligament, the most robust. In addition, it was found connected to the first metacarpal and the first hook 3,4 between the longitudinal joints between bone ligament (longitudinal interosseous ligament), the main connection of this Section 3 ligaments and head-shaped metacarpal bone. Joint between the first hook, there are connection beam (interconnecting bands), it starts from the first hook joint volar ligaments, vertical hook ends to the dorsal bone. We dissected and found trapezoid-shaped bone between the head, there are three kinds of interosseous ligament, the dorsal and deep palmar interosseous ligament, which tend to deep dorsal interosseous ligaments, tough. Size of the joint between the trapezoid has 3 interosseous ligament, dorsal, volar interosseous ligament and deep, deep volar interosseous ligament bias. 4 carpometacarpal joint at the proximal metacarpal ligament Dzwierzynski [19] (1997) reported the first 2 to 5 carpometacarpal joint at the proximal metacarpal ligament anatomic results. 4 ligaments found that the dorsal metacarpal ligaments, palmar metacarpal ligaments and 2, arranged in different directions Where 5 distal radioulnar joint ligaments the past will be divided into palmar and dorsal ligaments, two ligaments of distal radius, respectively, starting from the foot palmar angle and foot dorsal horn, via the triangular fibrocartilage of the palm side of the edge and dorsal margin, only in the ulnar styloid Department. KlEInman [20] (1998) report will be divided into lower, 3 palmar and dorsal part, although the lower and palmar and dorsal part of the full continuum, but it does not like the palmar and dorsal part of the thin, flat, and is very tough, fibrous membrane between bone to its exterior. Palmar part of the thin, loose, with pocket to accommodate the distal ulna and radius and ulna rotate the needs of the remote back-sliding. Unlike the dorsal part of the volar part of the relaxation, there are oblique fibers and little finger extensor tendon sheath dorsal to strengthen, to limit the distal ulna before and after the shift. 6 carpal ligament biomechanical properties Weaver [21] (1994) Part of the volar wrist ligament tension, in a different state of motion change, did a study and found that the palmar ligaments are always in tension, and even if there is no neutral position wrist weight. Neutral position, the triangular ligament and the radial head and distal part of the boat force head ligament; radial deviation, the radial ligament force; ulnar deviation, the ulnar ligament force; pronation, the radial head ligament proximal part of the boat by force; supination force when the foot ligament; dorsiflexion, the foot ligament, radial ligament and radial head ligament boat force. In any position, some of the tension of ligament tension than the other major ligament. Radial ligament, foot ligament and radial head ligament tension boat maximum, while the triangular ligament and the boat on the size of the first polygonal-shaped bone ligament tension minimum. Savelberg [22] (1991) movement of the wrist and dorsal part of the palmar ligaments of the length changes done. Palmar and dorsal radial ligament radial head boat triangular ligament, Wrist change the maximum length of the ulnar and radial deviation when compared with large. Maximum radial deviation compared with the neutral position when there is no significant elongation of ligaments. Maximum ulnar deviation, the radial head boat ligament, radial ligament, triangular ligament of the proximal part of the head and dorsal carpal ligaments is significantly higher than the neutral position elongation. Maximum dorsiflexion, the radial head boat ligament, the distal radial part of ligament and triangular ligaments of the proximal part of the elongation of the first obvious dorsal carpal ligaments shorten. The largest wrist flexion, only slight elongation of the dorsal carpal ligament, no significant elongation of the remaining ligament, radial head boat ligament, radial head ligament and triangular ligament was significantly reduced. May triangular volar ligament, regardless of any wrist movement, its length did not change significantly. Also noted the broad ligament near and far sides of the length of the change is different. Such as ulnar deviation, the radial ligament of the distal elongation, while the proximal part of the no change; triangular ligament of the distal part of the head shorter, and the proximal part of no change. Dorsiflexion, the triangular ligament of the proximal part of the elongated head, and the distal part of no change. Crison [23] (1997) studied the in vivo exercise activities on the stiffness of carpal ligaments, the wrist of the physical activity that can significantly reduce the stiffness of the wrist ligaments, carpal displacement activity increased. Rest 1h, the stiffness of the wrist ligaments partially recovered to the level before the event. Activity after 24h as before. Wrist shows physical activity can reduce the stiffness of the wrist ligaments, an increase of wrist joint laxity, can reduce the damage caused by the movement. injury caused carpal ligaments of the wrist joint instability, such as scapholunate separation, month triquetrum instability, many methods of treatment, but the results are sometimes not sure. Recently Shin [24] (1988) compared the scapholunate interosseous ligament and dorsal part of the Lister tubercle 3 of the extensor tendon biomechanical properties and histological characteristics, although 3 of the breaking strength of extensor tendon over scapholunate interosseous ligament of the dorsal part of the much smaller, but the breaking strength per unit area differed little between the two similar histological features. Weiss [25] (1988) in clinical use at both ends with the first 3 radius transplantation for treatment of extensor tendon scapholunate separation 19 patients, including 14 patients with dynamic scapholunate separation, the pain disappeared in 12 cases, 2 cases of wrist pain during heavy physical activity; and 5 cases of static scapholunate separation, the pain disappeared in 2 cases, 1 case of wrist pain and heavy physical activity, 2 patients continued pain. That the use of both ends of the first 3 radius transplantation for treatment of extensor tendon with dynamic scapholunate separation effect is possible, and treatment of static scapholunate separation of poor results, the reason is the 3 extensor enough to support the strength of ligaments. Can find both ends of the bones, cut easily, ligament strength and wrist for better close ligament rupture area, needs further study.
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