Humeral Head Translation and Contact Area Change Following Repair of Anterior Glenohumeral Instability

目前雖有許多手術被用來治療前窩肱骨關節前位不穩定，然而對縫合後關節之生物力學了解仍有限，本實驗之目的是評估縫合手術後是否能回復淺窩肱骨關節正常之力學狀態。共有八個屍體肩關節作為實驗材料。施行六種臨床手法檢查，包括外展、前屈、後伸、內旋、外旋，前懼怕試驗。利用Instrumented spatial linkage(ISC)測量肩關節三度空間之活動。淺窩肱骨關節接觸面可由關節面座標點之轉換及ISL輸出測量之。經由關節切開製造Bankart病灶後，以三種手術方法(傳統Bankart縫合，過緊之Bankart縫合及關節被囊十字縫合)修補Bankart病灶，本實驗結果顯示此三種縫合手術皆無法回復正常關節的力學狀態，會早成肱骨頭向後移位及淺窩肱骨關節接觸面之改變。

關鍵字

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並列摘要

Although many surgical procedures are currently used to repair anterior instablility of the glenohumeral joint, the biomechanics of the repaired joint is poorly understood. The purpose of this in vitro study was to assess the normalcy and reproducibility of the immediate postoperative mechanical status of the glenohumeral joint following repair. Eight fresh cadaveric glenohumeral joints were prepared for testing. Six clinical maneuvers,including maximum abduction,flexion, extension, internal rotation, external rotation,and anterior apprehension test were applied. An instrumented spatial linkage was used to measure three-dimensional joint motion.Glenohumeral contact area was predicted by digitizing the grid points on the articular surface and transforming these grids to their positions in the test status using the instrumented spatial linkage output. A full Bankart lesion was created via an arthrotomy. Three surgical procedures (classic Bankart repair, overtight Bankart repair and capsular shift repair) were used to repair the lesion. All of the repairs produced posterior translation of the humeral head compared to the normal joints. Contact area of the glenohumeral joint generally changed following repair procedures. The mechanical status of the repaired joint was neither reproducible nor normal.

並列關鍵字

anterior glenohumeral instability ； humeral head translation ； contact area

國際替代計量

Humeral Head Translation and Contact Area Change Following Repair of Anterior Glenohumeral Instability

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