肘关节稳定性的应用解剖和生物力学研究

目的 :为临床认识和治疗急、慢性肘关节不稳定提供基础。方法 :解剖观察肘关节副韧带的形态结构特点 ,测量依序切断桡侧软组织 (包括桡侧副韧带 )时肘关节后外侧旋转度的变化、依序切断肘关节尺侧副韧带时其外翻旋转角度的变化。结果 :①尺侧副韧带前束可分为前部纤维和后部纤维 ;桡侧副韧带部分止于环状韧带 ,部分止于尺骨冠突的外下方。②屈曲 60°以前 ,尺侧副韧带前束的外侧部紧张而内侧部较松弛 ,肘关节屈曲超过 60°后 ,前束内外侧处于同等程度的紧张状态 ;后束在肘关节屈曲超过 90°后才被拉紧。③肘关节桡侧副韧带复合体对维持关节外侧的稳定作用约占 5 0 % ,伸肌及伸肌腱膜起协同作用。结论 :肘关节副韧带是维持肘关节稳定的重要结构 ,在肘关节的运动过程中 ,副韧带的不同组成部分发挥着不同的作用 ,其中桡侧尺副韧带和尺侧副韧带前束是肘关节主要的稳定结构

Applied anatomy and biomechanical study of elbow stability

Objective: To provide the anatomic basis for clinical recognizing and therapy of elbow instability.Methods:The characteristics of the collateral ligament of elbow were dissected and observed, and the collateral ligament were sectioned serially to study the stability of the elbow.Results:The anterior bundle of ulnar collateral ligament was composed of anterior and posterior band.The radial collateral ligament arised from the inferior aspect of the lateral epicondyle.Two types of conjoined radial collateral and annular ligamentous insertions on the ulna were observed.The primary stabilizers were the radial collateral ligament complex and the secondary stabilizer were the extensor mass and its fascia.At 30 and 60 degrees of flexion,the posterior band was primary restraint and the anterior band was co primary part.The posterior bundle was secondary restraint only at 30 and 120 degrees flexion.Conclusions:The collateral ligaments of the elbow are important elements in keeping elbow stability.And the ligaments had distinct roles as the elbow flexion and extension in which the radial unlar collateral ligamnet and the anterior bundle of the unlar collateral ligament were the primary stabilizers.