| 研究生: |
周美綾 Chou, Mei-Ling |
|---|---|
| 論文名稱: |
拇指腕掌關節之接觸力學 Contact Mechanics of the Thumb Carpometacarpal Joint |
| 指導教授: |
蘇芳慶
Su, Fong-Chin |
| 共同指導教授: |
張志涵
Chang, Chih-Han |
| 學位類別: |
碩士 Master |
| 系所名稱: |
工學院 - 醫學工程研究所 Institute of Biomedical Engineering |
| 論文出版年: | 2011 |
| 畢業學年度: | 99 |
| 語文別: | 英文 |
| 論文頁數: | 57 |
| 中文關鍵詞: | 退化性關節炎 、腕掌關節 、接觸 、位移 、旋轉 |
| 外文關鍵詞: | osteoarthritis, carpometacarpal, contact pattern, translation, rotation |
| 相關次數: | 點閱:117 下載:2 |
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手拇指腕掌關節退化性關節炎對於上肢疾病中重要議題之一,然而從臨床結果顯示,針對此關節的多樣治療方法仍有許多不適處。最大主因為現今對於手拇指腕掌關節生物力學特性沒有明確瞭解,所以本篇實驗目的要探討手拇指腕掌關節的基本接觸特性。
本研究提出大體實驗去探討手拇指腕掌關節在不同受力模組的接觸機械性質,實驗內容包含給予每一條影響腕掌關節的肌腱做不同的力量附載以及模擬大體做功能性捏力動作,從電腦斷層影像去取得拇指腕掌關節在力量負載下的骨頭幾何模型,再以此三維模型去計算在不同力量附載下拇指腕掌關節的接觸性質以及旋轉位移量化描述關節特性。
本篇結果顯示手拇指掌側肌腱造成腕掌關節接觸在掌側以及掌骨較小的位移量相反的背側肌腱則形成背側接觸以及較大的位移量。而在捏力實驗結果顯示,腕掌關節接觸在掌骨上的橈骨後側 (dorsal-radial) 區域,此為較不穩定的接觸情況。
The osteoarthritis (OA) of thumb carpometacarpal (CMC) joint is a critical disease in upper extremity. However, up to now, the clinical outcomes of various treatments for OA especially in thumb CMC joint were unsatisfactory. The insufficient knowledge of biomechanics for thumb CMC joint is one of main factors. Therefore, the purpose of this study is to investigate basic contact modes of thumb CMC joint.
The study used cadaveric experiments to investigate contact mechanics of thumb CMC joint with two loading modes including: loading the tendon individually and the simulation of lateral pinch function posture. The position of trapezium and metacarpal of CMC joint under loading were obtained from CT image. Three-dimensional biomechanical model was developed to calculate the motion pattern, translation and rotation of CMC joint under various loadings.
The results showed that palmar tendons (FPL, APB, and ADD) caused contact on palmar region with smaller displacement while dorsal tendons (EPL and APL) resulted in contact region on dorsal region with larger displacement. In lateral pinch, the main contact was on dorsal-radial region of trapezium which might indicate an unstable condition.
1. Cooney, W.P., 3rd, et al., The kinesiology of the thumb trapeziometacarpal joint. J Bone Joint Surg Am, 1981. 63(9): p. 1371-81.
2. Joint Contact Stress.
3. Smutz, W.P., et al., Mechanical advantage of the thumb muscles. Journal of Biomechanics, 1998. 31(6): p. 565-570.
4. Pellegrini, V.D., Jr., C.W. Olcott, and G. Hollenberg, Contact patterns in the trapeziometacarpal joint: the role of the palmar beak ligament. J Hand Surg Am, 1993. 18(2): p. 238-44.
5. Bettinger, P.C., et al., An anatomic study of the stabilizing ligaments of the trapezium and trapeziometacarpal joint. J Hand Surg Am, 1999. 24(4): p. 786-98.
6. Nanno, M., et al., Three-dimensional analysis of the ligamentous attachments of the first carpometacarpal joint. J Hand Surg Am, 2006. 31(7): p. 1160-70.
7. Colman, M., D.P. Mass, and L.F. Draganich, Effects of the deep anterior oblique and dorsoradial ligaments on trapeziometacarpal joint stability. J Hand Surg Am, 2007. 32(3): p. 310-7.
8. Chiavaras, M.M., et al., Sonography of the anterior oblique ligament of the trapeziometacarpal joint: a study of cadavers and asymptomatic volunteers. AJR Am J Roentgenol, 2010. 195(6): p. W428-34.
9. Armstrong, A.L., J.B. Hunter, and T.R. Davis, The prevalence of degenerative arthritis of the base of the thumb in post-menopausal women. J Hand Surg Br, 1994. 19(3): p. 340-1.
10. Xu, L., et al., Topography of the osteoarthritic thumb carpometacarpal joint and its variations with regard to gender, age, site, and osteoarthritic stage. J Hand Surg Am, 1998. 23(3): p. 454-64.
11. Kovler, M., et al., The human first carpometacarpal joint: osteoarthritic degeneration and 3-dimensional modeling. J Hand Ther, 2004. 17(4): p. 393-400.
12. Pelligrini, V.D., Jr., Osteoarthritis of the trapeziometacarpal joint: the pathophysiology of articular cartilage degeneration. II. Articular wear patterns in the osteoarthritic joint. J Hand Surg Am, 1991. 16(6): p. 975-82.
13. Pellegrini, V.D., Osteoarthritis at the Base of the Thumb. Orthopedic Clinics of North America, 1992. 23(1): p. 83-102.
14. Pellegrini, V.D., C.W. Olcott, and G. Hollenberg, Contact Patterns in the Trapeziometacarpal Joint - the Role of the Palmar Beak Ligament. Journal of Hand Surgery-American Volume, 1993. 18A(2): p. 238-244.
15. Pellegrini, V.D., R.L. Smith, and C.W. Ku, Pathobiology of Articular-Cartilage in Trapeziometacarpal Osteoarthritis .2. Surface Ultrastructure by Scanning Electron-Microscopy. Journal of Hand Surgery-American Volume, 1994. 19A(1): p. 79-85.
16. Doerschuk, S.H., et al., Histopathology of the palmar beak ligament in trapeziometacarpal osteoarthritis. J Hand Surg Am, 1999. 24(3): p. 496-504.
17. Ateshian, G.A., et al., Contact areas in the thumb carpometacarpal joint. J Orthop Res, 1995. 13(3): p. 450-8.
18. Koff, M.F., et al., Sequential wear patterns of the articular cartilage of the thumb carpometacarpal joint in osteoarthritis. J Hand Surg Am, 2003. 28(4): p. 597-604.
19. Cheze, L., et al., A joint coordinate system proposal for the study of the trapeziometacarpal joint kinematics. Comput Methods Biomech Biomed Engin, 2009. 12(3): p. 277-82.
20. Moulton, M.J., et al., Influence of metacarpophalangeal joint position on basal joint-loading in the thumb. J Bone Joint Surg Am, 2001. 83-A(5): p. 709-16.
21. Koebke, J., A biomechanical and morphological analysis of human hand joints. Adv Anat Embryol Cell Biol, 1983. 80: p. 1-85.