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通过生物力学研究,探讨腕创伤性舟月骨分离及临床并发症的生物力学机制和治疗要求.方法 采用7只新鲜冷冻尸体上肢,分别在腕关节完整、舟月骨间韧带切断、中度及重度舟月骨间隙增大四个实验阶段测定腕关节屈伸和尺桡偏运动时,腕主要运动肌腱的滑动距离,并根据滑动距离和关节运动角度与力臂之间的关系计算肌腱力臂.结果 在舟月骨间韧带切断后腕屈伸运动时桡侧伸腕肌键的力臂明显增大;在舟月骨间韧带切断及舟月骨间隙增大时,腕屈伸或尺桡偏时桡侧腕屈肌力臂显著增大;在腕尺桡偏时,除桡侧腕屈肌力臂显著增大外,其余显著减小.结论 舟月骨间韧带的完整及舟月骨间隙对腕运动肌腱的功效有重要意义,腕肌腱力臂变化可能成为腕塌陷及退变的动力学原因,提示恢复正常腕关节动力学应成为舟月骨分离治疗的目标.“,”Objective To investigate pathomechanics of traumatic scapho-lunate dissociation and kinetic requirement of its treatment. Methods Seven fresh frozen cadaver upper extremity specimens were used. Excursions of the primary wrist movements were measured during wrist flexion, extension and radioulnar deviation. The study was performed in 4 stages: intact wrist, scapho-lunate interosseous ligament (SLIL) sectioning, moderate and severe scapho-lunate gaps. Moment arms were calculated according to relationship between tendon excursion and joint motion. Results Moment arms of the radial extensors increased signif- icantly after SLIL sectioning. Moment arms of the flexor carpi radial is tendon increased significantly in all stages of scapho-lunate dissociation. During radioulnar deviation, moment arms decreased significantly in all the tendons except flexor carpi radialis increased. conclusion integrity of the SLIL and normal scapho-lunate gap play an important role in wrist kinetics. Changes of the wrist motor tendons may be the pathogenesis of carpal collapse and joint degeneration. The study also indicates that restoration of wrist kinetics should be a goal in treatment of scapho-lunate dissociation.