Analysis on anatomy and biomechanics of ligaments in carpometacarpal joints of the thumb and clinical significance / 医用生物力学

Objective To study the anatomic and biomechanical characteristics of the dorsal radial ligament and anterior oblique ligament in carpometacarpal (CPC) joints of the thumb, so as to provide references for ligament repair. Methods Forty fresh hand specimens of adult male cadavers were dissected to make specimen of trapezium bone- ligament-the first metacarpal bone, of which 20 cases retained the dorsal radial ligament and 20 cases retained the anterior oblique ligament, respectively. The ligaments were tested on the biomechanical testing machine, and their length, width, thickness, the maximum load, elastic modulus and elongation rate were measured and calculated. Results For the dorsal radial ligament and anterior oblique ligament, their maximum load was (213.5±72.4) and (168.7±35.2) N, their elastic modulus was (17.2±6.7) and (9.3±2.5) N/mm2, their elongation rate was (116.2±21.3)% and (92.7±22.4)%, respectively. The maximum load, elastic modulus and elongation of the dorsal radial ligament were larger than that of the anterior oblique ligament. Conclusions In the capsular ligament in CPC joints of the thumb, the dorsal radial ligament has a higher stiffness and stronger toughness, which plays an important role in maintaining the stability of the joint. The stiffness of the anterior oblique ligament is smaller, the toughness is poor, which is easy to be damaged. The anterior oblique ligament is suggested to be reconstructed firstly to treat arthritis of CMC joints, and material whose elastic modulus and elongation rate is similar with the dorsal radial ligament should be selected.

Analysis on anatomy and biomechanics of ligaments in carpometacarpal joints of the thumb and its clinical significance / 医用生物力学

Objective To study the anatomic and biomechanical characteristics of the dorsal radial ligament and anterior oblique ligament in carpometacarpal (CPC) joints of the thumb,so as to provide references for ligament repair.Methods Forty fresh hand specimens of adult male cadavers were dissected to make specimen of trapezium bone-ligament-the first metacarpal bone,of which 20 cases retained the dorsal radial ligament and 20 cases retained the anterior oblique ligament,respectively.The ligaments were tested on biomechanical testing machine,and their length,width,thickness,the maximum load,elastic modulus and elongation rate were measured and calculated.Results For the dorsal radial ligament and anterior oblique ligament,their maximum load was (213.5 ±72.4) and (168.7 ±35.2) N,their elastic modulus was (17.2 ±6.7) and (9.3 ±2.5) MPa,their elongation rate was (116.2 ± 21.3) ％ and (92.7 ± 22.4) ％,respectively.The maximum load,elastic modulus and elongation of the dorsal radial ligament were larger than those of the anterior oblique ligament.Conclusions For the capsular ligament in CPC joints of the thumb,the dorsal radial ligament has a higher stiffness and stronger toughness,which plays an important role in maintaining stability of the joint.The anterior obligue ligament is easy to be damaged due to its smaller stiffness and poor toughness.The anterior oblique ligament is suggested to be reconstructed firstly to treat arthritis of CMC joints,and materials whose elastic modulus and elongation rate are similar with the dorsal radial ligament should be selected.

Analysis on anatomy and biomechanics of ligaments in carpometacarpal joints of the thumb and its clinical significance / 医用生物力学

Objective To study the anatomic and biomechanical characteristics of the dorsal radial ligament and anterior oblique ligament in carpometacarpal (CPC) joints of the thumb,so as to provide references for ligament repair.Methods Forty fresh hand specimens of adult male cadavers were dissected to make specimen of trapezium bone-ligament-the first metacarpal bone,of which 20 cases retained the dorsal radial ligament and 20 cases retained the anterior oblique ligament,respectively.The ligaments were tested on biomechanical testing machine,and their length,width,thickness,the maximum load,elastic modulus and elongation rate were measured and calculated.Results For the dorsal radial ligament and anterior oblique ligament,their maximum load was (213.5 ±72.4) and (168.7 ±35.2) N,their elastic modulus was (17.2 ±6.7) and (9.3 ±2.5) MPa,their elongation rate was (116.2 ± 21.3) ％ and (92.7 ± 22.4) ％,respectively.The maximum load,elastic modulus and elongation of the dorsal radial ligament were larger than those of the anterior oblique ligament.Conclusions For the capsular ligament in CPC joints of the thumb,the dorsal radial ligament has a higher stiffness and stronger toughness,which plays an important role in maintaining stability of the joint.The anterior obligue ligament is easy to be damaged due to its smaller stiffness and poor toughness.The anterior oblique ligament is suggested to be reconstructed firstly to treat arthritis of CMC joints,and materials whose elastic modulus and elongation rate are similar with the dorsal radial ligament should be selected.

A prospective randomized control clinical trial about clopidogrel combined with warfarin versus clopidogrel alone in the prevention of restenosis after femoral-popliteal artery angioplasty / 中华外科杂志

<p><b>OBJECTIVE</b>Using two antithrombotic treatment (clopidogrel vs. clopidogrel combined warfarin) strategies after femoral-popliteal artery angioplasty prospectively, to evaluate which strategy is more effective for the restenosis prevention.</p><p><b>METHODS</b>Totally 50 patients referred for endovascular treatment (including the percutaneous transluminal angioplasty (PTA) and stent implantation) of the superficial femoral artery and popliteal artery from January 2008 to May 2009 were randomly divided into clopidogrel group (group A, 25 cases, 30 limbs) and clopidogrel plus warfarin group (group B, 25 cases, 33 limbs) before operation. Clinical outcomes and restenosis rate of the target lesions were evaluated at 3, 6 and 12 months after operation.</p><p><b>RESULTS</b>Totally 88 patients were screened for participation in the study, 56 patients were included after the follow-up of 12 months. At 3 months, the rates of restenosis were 16.7% in group A and 18.2% in group B (χ² = 0.025, P = 0.874). At 6 months, the accumulated restenosis rates were 36.7% in group A and 36.4% in group B (χ² = 0.001, P = 0.98). At 12 months, the accumulated restenosis rates were 53.3% in group A and 42.4% in group B (χ² = 0.75, P = 0.387). Analysis for the critical limb ischemia sub-group showed that follow-up of 12 months, the accumulated restenosis rate was 8/10 in group A and 6/12 in group B (χ² = 1.023, P = 0.312).</p><p><b>CONCLUSION</b>The clopidogrel alone treatment for PTA or PTA plus stent implantation of femoral popliteal artery has no statistically significant difference in comparison with the clopidogrel combined warfarin treatment in terms of the cumulative vascular restenosis rate at 3, 6, 12 months postoperatively.</p>