タイトル（掲載誌）BMC musculoskeletal disorders
一般注記type:Thesis
BACKGROUND: Isolated radial head dislocation is a rare injury with an unclear pathomechanism, and the treatment is controversial. The purpose of the present study was to investigate the biomechanical contributions of the annular ligament, quadrate ligament, interosseous membrane, and annular ligament reconstructions to proximal radioulnar joint stability. METHODS: Five fresh frozen cadaveric upper extremities were amputated above the elbow and solidly fixed on a customized jig. Radial head dislocation was reproduced by sequential sectioning of ligamentous structures and passive mobility testing. Radial head displacement during mobility testing was measured with an electromagnetic tracking device in three forearm rotation positions. The data were compared among different sectioning stages and between two types of simulated ligamentous reconstruction. RESULTS: Lateral displacement of the radial head significantly increased in the neutral forearm rotation after annular ligament sectioning (46 ± 10%, p < 0.05). After quadrate ligament sectioning, we found significant posterior (67 ± 36%, p < 0.05) and lateral (74 ± 24%, p < 0.01) displacement in neutral forearm rotation and pronation. Significant radial head displacement was found in all directions and in all forearm positions after sequential sectioning of the proximal half of the interosseous membrane. Anatomical annular ligament reconstruction stabilized the proximal radioulnar joint except for anterior laxity in neutral forearm rotation (15 ± 6%, p < 0.05). The radial head with Bell Tawse procedure was significantly displaced in all directions. CONCLUSION: The direction of radial head instability varied depending on the degree of soft tissue sectioning and specific forearm rotation. Anterior radial head dislocation may involve more severe ligament damage than other types of dislocation. Anatomical annular ligament reconstruction provided multidirectional radial head stability.
博士（医学）・甲第683号・平成30年3月15日
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identifier:BMC musculoskeletal disorders Vol.18 No.1 Article No.470 (2017 Nov)
identifier:14712474
identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3428
identifier:BMC musculoskeletal disorders, 18(1): Article No.470
関連情報（DOI）10.1186/s12891-017-1829-1
連携機関・データベース国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）
提供元機関・データベース奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU