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目的通过MRI技术探讨桡腕关节在不同运动模式下的在体运动特点和规律。方法健康志愿者12名,行右腕投掷平面(桡背伸25°、50°,掌尺屈10°、20°)、屈伸平面(屈曲0°、25°、50°、75°,背伸20°、40°、60°)和桡尺偏(桡偏10°、20°,尺偏20°、40°)平面运动模式下共15个体位的MRI检查。MRI图像数据输入自行研发的腕关节运动学测量平台软件,分析舟骨、月骨和三角骨分别相对于桡骨在横断面、矢状面和冠状面的运动规律。结果在投掷平面运动模式中,当腕关节从背伸桡偏位向掌屈尺偏位运动时,舟骨、月骨、三角骨相对于桡骨的旋后分别为11°、11°、19°,掌屈21°、-2°、6°,桡偏3°、3°、11°。在屈伸平面运动模式中,当腕关节从背伸位向掌屈位运动时,舟骨、月骨、三角骨相对于桡骨的旋后分别为9°、7°、9°,掌屈44°、-4°、11°,桡偏7°、22°、25°。在桡尺偏平面运动模式中,当腕关节从桡偏向尺偏运动时,舟骨、月骨、三角骨相对于桡骨的旋后分别为8°、15°、20°,掌屈-9°、6°、2°,尺偏8°、14°、6°。结论桡腕关节的运动是在空间中的三维复合运动,以矢状面的运动最为显著。舟骨在矢状面上运动幅度明显大于月骨和三角骨,近排腕骨间存在显著的适应性运动。
Objective To investigate the characteristics and laws of in-body movement of radiocarpal joint under different exercise modes by MRI. Methods 12 healthy volunteers were performed with the right wrist cast plane (radius 25 °, radius 50 °, palmar flexion 10 °, 20 °), flexion and extension planes (flexion 0 °, 25 °, 50 °, 75 °, dorsiflexion 20 °, 40 °, 60 °) and radial ulnar deviation (radial deviation of 10 °, 20 °, ruler 20 °, 40 °) plane motion mode of 15 body MRI examination. The MRI data was input into the self-developed wrist motion measurement platform software to analyze the motion of the scaphoid, lunate and trochanter with respect to the radius in the transverse, sagittal and coronal planes respectively. Results In the throwing plane mode of motion, the posterior rotation of the scaphoid, lunate and trigone relative to the radius were 11 °, 11 ° and 19 °, respectively, when the wrist was deviated from the dorsiflexion to the flexor flexion. Palm flexion 21 °, -2 °, 6 °, radial deviation 3 °, 3 °, 11 °. In the flexion-extension plane movement mode, the posterior rotation of the navicular, lunate, and trigone relative to the radius was 9 °, 7 °, 9 °, and 44 ° respectively when the wrist was moved from dorsiflexion to palmar flexion. -4 °, 11 °, radial deviation 7 °, 22 °, 25 °. In the radial ulnar plane movement mode, the rotation of the navicular, lunate, and trigone relative to the radius were 8 °, 15 °, 20 °, and 9 °, respectively, when the wrist was moved from the radial to the ulnar. 6 °, 2 °, ruler 8 °, 14 °, 6 °. Conclusion The movement of the radiocarpal joint is a three-dimensional complex movement in space, and the sagittal plane movement is the most significant. Scaphoid movement in the sagittal plane was significantly greater than the lunate and triangular bones, near the wrist between the significant adaptive exercise.