正常人腕骨在主动活动中的运动变化

发布时间：2018-03-05 08:27

本文选题：腕关节　切入点：主动活动　出处：《天津医科大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的：测量活体腕骨在腕关节主动屈曲、背伸、尺偏及桡偏时的运动变化。方法：以7名成年志愿者的优势侧腕部作为标本,每一腕关节在中立位、最大主动屈曲位、最大主动背伸位、最大主动尺偏位和最大主动桡偏位进行CT扫描,利用CT工作站获得腕骨的容积再现图像和多平面重组图像,以中立位为参照,在多平面重组图像中测量每块腕骨在腕关节每一位置时相对于桡骨的角度变化数值,并结合容积再现图像分析腕骨的运动变化。结果：腕关节最大主动屈曲时,舟骨屈曲46.9°±5.8°,尺偏9.3°±5.9°；月骨屈曲39.4°±4.0°,尺偏6.3°±4.5°；三角骨屈曲42.7°±3.4°,尺偏8.0°±3.0°；豌豆骨屈曲52.4°±6.6°,桡偏2.1°±3.2°；大多角骨屈曲70.3°±9.1°,尺偏9.0°±3.6°；小多角骨屈曲71.3°±7.0°,尺偏3.0°±2.9°；头状骨屈曲73.7°±4.0°,尺偏5.4°±3.9°；钩骨屈曲72.7°±7.8°尺偏4.7°±2.0°。腕关节最大主动背伸时,舟骨背伸54.1°±5.8°,尺偏7.6°±2.4°；月骨背伸27.7°±5.2°,尺偏7.0°±3.4°；三角骨背伸44.2°±5.1°,桡偏7.4°±3.2°；豌豆骨背伸44.7°±5.9°,桡偏7.9°±1.9°；大多角骨背伸57.1°±8.5°,尺偏14.6°±5.0°；小多角骨背伸68.4°±7.0°,桡偏7.9°±5.4°；头状骨背伸62.9°±7.7°,桡偏9.4°±3.8°；钩骨背伸41.7°±4.7°,桡偏9.3°±4.1°。各腕骨在屈伸时还有一定的旋转变化。腕关节最大主动桡偏时舟骨桡偏12.1°±1.9°,屈曲13.9°±3.1°；月骨桡偏10.0°±1.6°,屈曲12.3°±2.3°；三角骨桡偏19.1°±4.1°,屈曲3.4°±2.4°；豌豆骨桡偏13.7°±3.9°,背伸6.4°±3.0°；大多角骨桡偏8.7°±3.9°,背伸12.9°±4.8°；小多角骨桡偏9.7°±2.3°,背伸11.0°±4.5°；头状骨桡偏7.6°±2.7°,背伸2.9°±1.6°；钩骨桡偏8.0°±2.3°,背伸1.7°±1.5°。腕关节最大主动尺偏时舟骨尺偏12.7°±3.1°,背伸24.1°±5.0°；月骨尺偏12.6°±2.5°,背伸19.7°±3.6°；三角骨尺偏17.0°±3.7°,背伸8.3°±2.6°；豌豆骨尺偏5.0°±3.4°,屈曲6.3°±3.3°；大多角骨尺偏29.6°±6.3°,屈曲25.0°±5.1°；小多角骨尺偏26.4°±8.1°,屈曲28.1°±7.0°；头状骨尺偏19.0°±4.1°,屈曲19.4°±5.2°；钩骨尺偏24.4°±3.9°,屈曲23.6°±5.9°。各腕骨在尺桡偏时,远近排腕骨还存在相向的旋转变化。结论：腕骨在腕关节活动时的运动变化是复杂的,在屈伸时近排腕骨间的活动变化相差大,远排腕骨的变化相差小,可以将远排腕骨看为整体活动。在尺桡偏运动时,远近排腕骨相向运动并存在相互抵偿的旋转运动趋势。
[Abstract]:Objective: to measure the motion changes of wrist in vivo during active flexion, dorsal extension, ulnar deviation and radial deviation. The maximum active dorsal extension position, the largest active ulnar deviation and the largest active radial deviation were scanned by CT. The volume reconstruction images and multiplanar reconstruction images of the wrist were obtained by using CT workstation, and the neutral position was used as the reference. The angle changes of each carpal bone relative to the radius at each position of the wrist joint were measured in a multiplanar recombination image, and the motion changes of the carpal bone were analyzed with volume reconstruction image. Results: the maximum active flexion of wrist joint, Scaphoid flexion 46.9 掳卤5.8 掳, ulnar deviation 9.3 掳卤5.9 掳, meniscus flexion 39.4 掳卤4.0 掳, ulnar deviation 6.3 掳卤4.5 掳, triangular bone flexion 42.7 掳卤3.4 掳, ulnar deviation 8.0 掳卤3.0 掳, pea flexion 52.4 掳卤6.6 掳, radial deviation 2.1 掳卤3.2 掳, mostly horn flexion 70.3 掳卤9.1 掳, ulnar deviation 9.0 掳卤3.6 掳, small multiangular bone flexion 71.3 掳卤7.0 掳, ulnar deviation 3.0 掳卤2.9 掳, head bone flexion 73.7 掳卤4.0 掳, ulnar deviation 5.4 掳卤3.9 掳, hook bone flexion 72.7 掳卤7.8 掳卤3.9 掳. 4.7 掳卤2.0 掳. Maximum active dorsal extension of wrist, Scaphoid bone dorsal extension 54.1 掳卤5.8 掳, ulnar deviation 7.6 掳卤2.4 掳, meniscus dorsal extension 27.7 掳卤5.2 掳, ulnar deviation 7.0 掳卤3.4 掳, deltoid bone dorsal extension 44.2 掳卤5.1 掳, radial deviation 7.4 掳卤3.2 掳, dorsal extension of pea bone 44.7 掳卤5.9 掳, radial deviation 7.9 掳卤1.9 掳; dorsal extension of mostly horned bone 57.1 掳卤8.5 掳, ulnar deviation 14.6 掳卤5.0 掳; dorsalis dorsalis 68.4 掳卤7.0 掳, deviation 7.9 掳卤5.4 掳; dorsal extension of cephalate bone 62.9 掳卤7.7 掳, radial deviation 9.4 掳卤3.8 掳; hook bone dorsal extension 41.7 掳卤4.7 掳, radial deviation 41.7 掳卤1.9 掳; dorsalis dorsalis dorsalis 68.4 掳卤7.0 掳, deviation 7.9 掳卤5.4 掳; dorsal extension of capitate bone 62.9 掳卤7.7 掳, radial deviation 9.4 掳卤3.8 掳. The radial deviation of scaphoid was 12.1 掳卤1.9 掳, flexion 13.9 掳卤3.1 掳, radial deviation of lunar bone 10.0 掳卤1.6 掳, flexion 12.3 掳卤2.3 掳, radial deviation of triangular bone 19.1 掳卤4.1 掳, flexion 3.4 掳卤2.4 掳, radial deviation of pea bone 13.7 掳卤3.9 掳, dorsal extension 6.4 掳卤3.0 掳; radial deviation of lunar bone 10.0 掳卤1.6 掳, flexion 12.3 掳卤2.3 掳; radial deviation of pea bone 13.7 掳卤3.9 掳, dorsal extension 6.4 掳卤3.0 掳; radial deviation of lunar bone 10.0 掳卤1.6 掳, flexion 12.3 掳卤2.3 掳; radial deviation of triangle 19.1 掳卤4.1 掳, flexion 3.4 掳卤2.4 掳. Extension 12.9 掳卤4.8 掳, radial deviation 9.7 掳卤2.3 掳, dorsal extension 11.0 掳卤4.5 掳, radial deviation 7.6 掳卤2.7 掳, dorsal extension 2.9 掳卤1.6 掳, radial deviation of hook 8.0 掳卤2.3 掳, extension 1.7 掳卤1.5 掳. Scaphoid ulnar deviation 12.7 掳卤3.1 掳, dorsal extension 24.1 掳卤5.0 掳, month bone 12.6 掳卤2.5 掳, dorsal extension 19.7 掳卤3.6 掳, radial deviation 17.0 掳卤3.7 掳, dorsal extension 8.3 掳卤2.6 掳, pea bone 5.0 掳卤3.5 掳, dorsal extension 19.7 掳卤3.6 掳, maximum active ulnar deviation of wrist joint 12.7 掳卤3.1 掳, dorsal extension 19.7 掳卤3.6 掳, radial deviation 17.0 掳卤3.7 掳, dorsal extension 8.3 掳卤2.6 掳. Flexion: 6.3 掳卤3.3 掳, 29.6 掳卤6.3 掳, 25.0 掳卤5.1 掳, 26.4 掳卤8.1 掳, 28.1 掳卤7.0 掳, 19.0 掳卤4.1 掳, 19.4 掳卤5.2 掳, 24.4 掳卤3.9 掳, 23.6 掳卤5.9 掳. The carpal bones in the far and near rows are also rotated in opposite directions. Conclusion: the movement change of carpal bone in wrist joint is complicated. The movement of carpal bone varies greatly between flexion and extension, and the change of distal carpal bone is small, so the distal carpal bone can be regarded as the whole movement. When ulnar radial movement, the carpal bone can be regarded as the whole movement. The carpal bones of the far and near rows move in opposite direction and there is a tendency of reciprocal rotation.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R322

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