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在逆肩关节整形手术后,胸关节带的完整性会影响头骨脊柱的紧张
Cole T Fleet1,2, Alicia Kerrigan1, G Daniel G Langohr1,2,3
1Roth, McFarlane Hand and Upper Limb Centre, St Joseph's Health Care, London, Canada.
JSES international
|February 3, 2025
概括
在逆向全肩关节整形手术 (rTSA) 期间释放心脏关节 (CA) 带会增加肩膀脊柱和关节的压力,特别是随着手臂的加伸. 这可能会增加术后头骨脊柱骨折的风险.
科学领域:
- 整形外科手术 整形外科手术
- 生物力学 生物力学
- 生物医学工程 生物医学工程
背景情况:
- 反向全肩关节整形手术 (rTSA) 是复杂的肩关节病理的一个常见手术.
- 了解手术决策的生物机械后果,例如心脏关节 (CA) 带释放,对于优化患者的治疗结果至关重要.
- 骨脊柱和骨完整性对于肩部在关节塑形术后的功能至关重要.
研究的目的:
- 为了研究心脏关节 (CA) 带状况 (完好或释放) 对头骨脊柱和关节应变的生物力学影响.
- 评估不同手臂位置 (绑架和向前提升) 在逆向全肩关节整形术 (rTSA) 后对这些菌株的影响.
主要方法:
- 采用了一个体外生物机械模型,用8个尸体肩部植入一个定制的RTSA系统.
- 采用肩部模拟器,通过定义的运动范围来施加循环负荷.
- 在完整和释放的CA带条件下,在不同的解剖位置使用四种张力计量量化骨脊柱和状脊柱的应变.
主要成果:
- 胸关节 (CA) 带释放导致0°绑架和向前升高的所有测量位置的应变增加.
- 平均应变增加达到14%的绑架和31%的前向升高.
- 在0°向前升高时始终观察到最大的应变,在90°绑架或释放后升高时没有显著增加.
结论:
- 在rTSA期间CA带的释放会增加骨脊柱和骨紧张,特别是当手臂被添加时.
- 建议在手术期间保持谨慎,因为CA带释放可能会改变由于三角体负荷而导致头骨脊柱和骨上的应力分布.
- 改变CA带释放后的生物力学可能会增加术后头骨脊柱骨折的风险.
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