發(fā)布時(shí)間：2018-03-05 08:27

  本文選題：腕關(guān)節(jié)　切入點(diǎn)：主動(dòng)活動(dòng)　出處：《天津醫(yī)科大學(xué)》2010年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的：測(cè)量活體腕骨在腕關(guān)節(jié)主動(dòng)屈曲、背伸、尺偏及橈偏時(shí)的運(yùn)動(dòng)變化。方法：以7名成年志愿者的優(yōu)勢(shì)側(cè)腕部作為標(biāo)本,每一腕關(guān)節(jié)在中立位、最大主動(dòng)屈曲位、最大主動(dòng)背伸位、最大主動(dòng)尺偏位和最大主動(dòng)橈偏位進(jìn)行CT掃描,利用CT工作站獲得腕骨的容積再現(xiàn)圖像和多平面重組圖像,以中立位為參照,在多平面重組圖像中測(cè)量每塊腕骨在腕關(guān)節(jié)每一位置時(shí)相對(duì)于橈骨的角度變化數(shù)值,并結(jié)合容積再現(xiàn)圖像分析腕骨的運(yùn)動(dòng)變化。 結(jié)果：腕關(guān)節(jié)最大主動(dòng)屈曲時(shí),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°,橈偏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°；頭狀骨屈曲73.7°±4.0°,尺偏5.4°±3.9°；鉤骨屈曲72.7°±7.8°尺偏4.7°±2.0°。腕關(guān)節(jié)最大主動(dòng)背伸時(shí),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°,橈偏7.4°±3.2°；豌豆骨背伸44.7°±5.9°,橈偏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°,橈偏7.9°±5.4°；頭狀骨背伸62.9°±7.7°,橈偏9.4°±3.8°；鉤骨背伸41.7°±4.7°,橈偏9.3°±4.1°。各腕骨在屈伸時(shí)還有一定的旋轉(zhuǎn)變化。腕關(guān)節(jié)最大主動(dòng)橈偏時(shí)舟骨橈偏12.1°±1.9°,屈曲13.9°±3.1°；月骨橈偏10.0°±1.6°,屈曲12.3°±2.3°；三角骨橈偏19.1°±4.1°,屈曲3.4°±2.4°；豌豆骨橈偏13.7°±3.9°,背伸6.4°±3.0°；大多角骨橈偏8.7°±3.9°,背伸12.9°±4.8°；小多角骨橈偏9.7°±2.3°,背伸11.0°±4.5°；頭狀骨橈偏7.6°±2.7°,背伸2.9°±1.6°；鉤骨橈偏8.0°±2.3°,背伸1.7°±1.5°。腕關(guān)節(jié)最大主動(dòng)尺偏時(shí)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°；頭狀骨尺偏19.0°±4.1°,屈曲19.4°±5.2°；鉤骨尺偏24.4°±3.9°,屈曲23.6°±5.9°。各腕骨在尺橈偏時(shí),遠(yuǎn)近排腕骨還存在相向的旋轉(zhuǎn)變化。 結(jié)論：腕骨在腕關(guān)節(jié)活動(dòng)時(shí)的運(yùn)動(dòng)變化是復(fù)雜的,在屈伸時(shí)近排腕骨間的活動(dòng)變化相差大,遠(yuǎn)排腕骨的變化相差小,可以將遠(yuǎn)排腕骨看為整體活動(dòng)。在尺橈偏運(yùn)動(dòng)時(shí),遠(yuǎn)近排腕骨相向運(yùn)動(dòng)并存在相互抵償?shù)男D(zhuǎn)運(yùn)動(dòng)趨勢(shì)。
[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 擄鹵5.8 擄, ulnar deviation 9.3 擄鹵5.9 擄, meniscus flexion 39.4 擄鹵4.0 擄, ulnar deviation 6.3 擄鹵4.5 擄, triangular bone flexion 42.7 擄鹵3.4 擄, ulnar deviation 8.0 擄鹵3.0 擄, pea flexion 52.4 擄鹵6.6 擄, radial deviation 2.1 擄鹵3.2 擄, mostly horn flexion 70.3 擄鹵9.1 擄, ulnar deviation 9.0 擄鹵3.6 擄, small multiangular bone flexion 71.3 擄鹵7.0 擄, ulnar deviation 3.0 擄鹵2.9 擄, head bone flexion 73.7 擄鹵4.0 擄, ulnar deviation 5.4 擄鹵3.9 擄, hook bone flexion 72.7 擄鹵7.8 擄鹵3.9 擄. 4.7 擄鹵2.0 擄. Maximum active dorsal extension of wrist, Scaphoid bone dorsal extension 54.1 擄鹵5.8 擄, ulnar deviation 7.6 擄鹵2.4 擄, meniscus dorsal extension 27.7 擄鹵5.2 擄, ulnar deviation 7.0 擄鹵3.4 擄, deltoid bone dorsal extension 44.2 擄鹵5.1 擄, radial deviation 7.4 擄鹵3.2 擄, dorsal extension of pea bone 44.7 擄鹵5.9 擄, radial deviation 7.9 擄鹵1.9 擄; dorsal extension of mostly horned bone 57.1 擄鹵8.5 擄, ulnar deviation 14.6 擄鹵5.0 擄; dorsalis dorsalis 68.4 擄鹵7.0 擄, deviation 7.9 擄鹵5.4 擄; dorsal extension of cephalate bone 62.9 擄鹵7.7 擄, radial deviation 9.4 擄鹵3.8 擄; hook bone dorsal extension 41.7 擄鹵4.7 擄, radial deviation 41.7 擄鹵1.9 擄; dorsalis dorsalis dorsalis 68.4 擄鹵7.0 擄, deviation 7.9 擄鹵5.4 擄; dorsal extension of capitate bone 62.9 擄鹵7.7 擄, radial deviation 9.4 擄鹵3.8 擄. The radial deviation of scaphoid was 12.1 擄鹵1.9 擄, flexion 13.9 擄鹵3.1 擄, radial deviation of lunar bone 10.0 擄鹵1.6 擄, flexion 12.3 擄鹵2.3 擄, radial deviation of triangular bone 19.1 擄鹵4.1 擄, flexion 3.4 擄鹵2.4 擄, radial deviation of pea bone 13.7 擄鹵3.9 擄, dorsal extension 6.4 擄鹵3.0 擄; radial deviation of lunar bone 10.0 擄鹵1.6 擄, flexion 12.3 擄鹵2.3 擄; radial deviation of pea bone 13.7 擄鹵3.9 擄, dorsal extension 6.4 擄鹵3.0 擄; radial deviation of lunar bone 10.0 擄鹵1.6 擄, flexion 12.3 擄鹵2.3 擄; radial deviation of triangle 19.1 擄鹵4.1 擄, flexion 3.4 擄鹵2.4 擄. Extension 12.9 擄鹵4.8 擄, radial deviation 9.7 擄鹵2.3 擄, dorsal extension 11.0 擄鹵4.5 擄, radial deviation 7.6 擄鹵2.7 擄, dorsal extension 2.9 擄鹵1.6 擄, radial deviation of hook 8.0 擄鹵2.3 擄, extension 1.7 擄鹵1.5 擄. Scaphoid ulnar deviation 12.7 擄鹵3.1 擄, dorsal extension 24.1 擄鹵5.0 擄, month bone 12.6 擄鹵2.5 擄, dorsal extension 19.7 擄鹵3.6 擄, radial deviation 17.0 擄鹵3.7 擄, dorsal extension 8.3 擄鹵2.6 擄, pea bone 5.0 擄鹵3.5 擄, dorsal extension 19.7 擄鹵3.6 擄, maximum active ulnar deviation of wrist joint 12.7 擄鹵3.1 擄, dorsal extension 19.7 擄鹵3.6 擄, radial deviation 17.0 擄鹵3.7 擄, dorsal extension 8.3 擄鹵2.6 擄. Flexion: 6.3 擄鹵3.3 擄, 29.6 擄鹵6.3 擄, 25.0 擄鹵5.1 擄, 26.4 擄鹵8.1 擄, 28.1 擄鹵7.0 擄, 19.0 擄鹵4.1 擄, 19.4 擄鹵5.2 擄, 24.4 擄鹵3.9 擄, 23.6 擄鹵5.9 擄. 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.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R322

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