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GLENOHUMERAL CAPSULE SHOULD BE EVALUATED AS A SHEET OF FIBROUS TISSUE: A STUDY IN FUNCTIONAL ANATOMY

机译:应将盂肱小囊评价为纤维组织表:功能解剖学研究

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摘要

Following glenohumeral joint dislocation, surgical repair is often advocated where the glenohumeral capsule is shifted and plicated. However, nearly 25% of patients still experience redislocations. To improve these results, functional evaluations (experimental and computational) of the glenohumeral capsule have been performed whereby isolated, discrete capsuloligamentous regions of the capsule were examined. Specifically, the capsuloligamentous region termed the anterior band of the inferior glenohumeral ligament is often examined in this way since it is frequently injured during dislocations. However, this practice may not be appropriate as recent data suggests that the glenohumeral capsule functions multiaxially. Therefore, the objective of this work was to compare the predicted strain distribution and deformed shape of the anterior band of the inferior glenohumeral ligament to that experimentally measured for two finite element models: 1) composite model including all capsuloligamentous regions and 2) discrete model including only the anterior band of the inferior glenohumeral ligament. The average maximum principal strain for the anterior band of the inferior glenohumeral ligament was 21±14%, 35±14%, and 0±1% for the experimental measurements, composite finite element model, and discrete finite element model, respectively. Thus, the predicted strain distribution in the anterior band of the inferior glenohumeral ligament was similar to that which was experimentally measured for the composite finite element model. Additionally, the predicted deformed shape in the composite finite element model was also similar to experimental data with the anterior band of the inferior glenohumeral ligament clearly wrapping around the humeral head. However, the predicted strain distribution and shape for the discrete finite element model was drastically different from that observed experimentally with the anterior band of the inferior glenohumeral ligament twisting somewhat along its longitudinal axis and buckling away from the humeral head. These differences may be attributed to neglecting the boundary conditions along the margins of the anterior band of the inferior glenohumeral ligament applied by the remaining capsuloligamentous regions. Thus, the glenohumeral capsule should be evaluated as a sheet of fibrous tissue and composite finite element models may be utilized to evaluate its function in the normal, injured, and surgically repaired state.
机译:盂肱关节脱位后,通常提倡外科手术修复,其中盂肱囊移位和折叠。但是,将近25%的患者仍会发生重定位。为了改善这些结果,已经对盂肱胶囊进行了功能评估(实验和计算),从而检查了胶囊的分离的,离散的荚膜韧带区域。具体地,由于这种脱位在肩关节韧带韧带区经常在脱位过程中受伤,因此常常以这种方式检查称为肩盂下韧带前带的囊膜韧带区域。但是,这种做法可能不合适,因为最近的数据表明,肱肱骨囊具有多轴功能。因此,这项工作的目的是将下肱骨韧带的预测应变分布和前带的变形形状与两个有限元模型的实验测量值进行比较:1)包括所有囊膜韧带区域的复合模型,以及2)包括仅下肱骨韧带的前带。对于实验测量,复合有限元模型和离散有限元模型,下肱骨韧带前带的平均最大主应变分别为21±14%,35±14%和0±1%。因此,下盂肱韧带前带的预计应变分布与复合有限元模型实验测得的相似。此外,复合有限元模型中预测的变形形状也与实验数据相似,下肱骨韧带的前带清楚地包裹在肱骨头周围。然而,对于离散的有限元模型,预测的应变分布和形状与实验观察到的完全不同,下盂肱韧带的前带沿其纵轴略微扭曲并远离肱骨头屈曲。这些差异可能归因于忽略了沿剩余肩cap韧带区域施加的下肱骨韧带前带边缘的边界条件。因此,应将盂肱胶囊评估为一片纤维组织,并且可以使用复合有限元模型来评估其在正常,受伤和手术修复状态下的功能。

著录项

  • 作者

    Moore Susan Marie;

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  • 年度 2006
  • 总页数
  • 原文格式 PDF
  • 正文语种 en
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