Kadavra önkollarında interosseöz membran ve radius başı ile ilgili biyomekanik bir çalışma

Abstract

Amaç: Çalışmanın amacı interosseöz membran (IOM) ve radius başının biyomekanik özelliklerini değerlendirmek ve Essex-Lopresti yaralanmasının patomekaniğini araştırmak. Çalışma planı: Test için insan kadavralarından elde edilmiş 12 taze donmuş erişkin üst ekstremitesi seçildi. Öncelikle 12 sağlam örnek sırasıyla pronasyon, supinasyon ve nötral pozisyonlarda biyomekanik test uygulamak amacıyla bir materyal test makinasına monte edildi. Örneklere her pozisyonda önkolun uzun ekseni boyunca 30 saniye süreyle 100 N’lik aksiyel yük uygulandı. Daha sonra 12 örnek rastgele iki gruba ayrıldı. Örneklerin 6’sında radius başı rezeke edildi. Diğer 6 örnekte IOM’un ortasındaki santral bant kesildi. Grupların hepsi aynı yöntemle test edildi. Son olarak, örneklerin hepsinde radius başı ve IOM eksize edilerek biyomekanik testler yapıldı. Bulgular: Önkolun rotasyonel pozisyonu veya sadece IOM’un kesilmesinin longitüdinal kayma üzerinde etkisi olmadı. Radius başının rezeksiyonundan sonra radiustaki longitüdinal kayma anlamlı oranda arttı. IOM’un kesilmesinin radiusun kompresif katılığı üzerinde etkisi olmadı. Bununla birlikte, radiusun kompresif katılığı radius başının rezeksiyonundan sonra anlamlı oranda azaldı. Çıkarımlar: Essex-Lopresti yaralanmasının en önemli nedeni IOM yaralanması ile birlikte görülen radius başı kırığı idi ve burada radius başı kırığı temel faktördü. Radius başının rezeksiyonu sonrasında önkolun longitüdinal stabilitesini koruyan en önemli yapının ise IOM olduğu saptandı.

Keywords

• Biyomekanik; Essex-Lopresti yaralanması; interosseöz membran; önkol; radius başı.

A biomechanical study on the interosseous membrane and radial head in cadaveric forearms

Abstract

Objective: Our aim was to evaluate the biomechanical properties of the interosseous membrane (IOM) and radial head and investigate the pathomechanics of the Essex-Lopresti injury.
Methods: Twelve adult fresh frozen upper limbs of human cadavers were chosen for test. First, the 12 intact specimens were mounted onto a materials testing machine to carry out biomechanical tests in pronation, supination and neutral positions, respectively. An axial load of 100 N was applied along the longitudinal axis of the forearm for 30 seconds in each position. Then, the twelve specimens were randomly divided into two groups. The radial head was resected in 6 specimens. And the central band of IOM was severed in another 6 specimens. Each group was tested by the same method. Finally, both the radial head and the IOM were excised in all specimens and biomechanical tests were performed.
Results: The rotational position of the forearm or simple severance of the IOM had no effect on longitudinal displacement. The radial longitudinal displacement increased significantly after resection of the radial head. The severance of the IOM had no effect on compressive stiffness of the radius. However, compressive stiffness of the radius decreased significantly after resection of the radial head.
Conclusion: The radial head fracture combined with the IOM injury was the most important cause of the Essex-Lopresti injury, and the radial head fracture was the major factor. The IOM was the major structure to maintain the longitudinal stability of the forearm after resection of the radial head. 

Keywords

• Biomechanical
• Essex-Lopresti injury
• forearm
• interosseous membrane
• radial head

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