对关节表面功能形态学的贡献。

Normale und pathologische Anatomie Pub Date : 1978-01-01
B Tillmann
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引用次数: 0

摘要

首先分析了人类髋臼和尺滑车切迹关节形状的变化。然后尝试从因果组织发生和关节应力的一般理论(Pauwels)以及完美球窝关节应力的理论分布(Kummer)来解释月骨面的基本形状和与之相分离的关节面类型。关于关节合力的位置、大小、方向变化和过程的某些陈述,与人类髋关节已知的事实相比,这些陈述似乎很可能是准确的。在这些前提条件下,观察到的各种形式的接合面理论上可以在任何情况下重建。在这方面,首先表明,关节软骨的保存也取决于时间期间的合力是有效的在关节表面的各个区域。术语“相对恒定”被用来表示这个时间因素。对于在月骨面和滑车切迹中存在切口和分裂,给出了两种功能上的解释:假定合力的“相对恒常性”在关节面不同区域的大小是不同的。因此,关节软骨的切口和分裂被视为关节应力不超过保护关节软骨的最小值的区域。2. 凸关节面半径可略大于凹关节面半径。由于这种不协调,由于接触不良,在月骨面或滑车切迹区域内不会传递压力。由此可见,保护软骨的刺激压力在这个区域也不存在。根据Pauwels的说法,关节表面产生的应力的大小和分布可以从x射线中看到的软骨下骨组织的不同密度分布来确定。尺窝软骨下骨的密度分布与关节软骨覆盖的表面范围基本平行。缺口区域相对较低的密度被认为是较低应力的结果,与软骨表面分裂的功能解释一致。在光弹性模型实验中,相对应力的程度对关节面形式的依赖是通过等色的数量来说明的。在这里,软骨下骨组织的密度分布对应于相应模型关节的局部应力大小。股骨头和肘关节关节软骨的切向纤维层的功能分析显示,分裂线模式和轨迹模式之间的基本一致,正如Pauwels, Konermann和Molzberger在关节面检查中所描述的……
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A contribution to the functional morphology of articular surfaces.

The variations of the joint shape are first analyzed in the acetabulum and the ulnar trochlear notch of man. Then an attempt is made to explain the basic shape of the lunate surface and the types of articular surface diverging from it with regard to causal histogenesis and the general theory of joint stress (Pauwels), as well as the theoretical distribution of stress in the perfect ball and socket joint (Kummer). Certain statements are made about the position, size, changes in direction and course of the resultant forces at the joint, statements which seem very likely to be accurate when compared to facts already known about the hip joint in man. Under these preconditions, the various forms of the observed articulating surfaces may be theoretically reconstructed in every case. In this connection, it is first shown that the preservation of the joint cartilage is also dependent on the period of time during which the resultant force is effective in the various areas of the articular surface. The term "relative constancy" is used to express this time factor. Two functional explanations are given for the presence of incisions and divisions in the lunate surface and in the trochlear notch: 1. It is assumed that the "relative constancy" of the resultant forces is of varying magnitude in the different areas of the articular surface. The incisions and divisions in the joint cartilage are thus seen as areas in which the resultant joint stress does not rise above the minimum value for preservation of the articular cartilage. 2. The radius of the convex articular surface can be slightly larger than the radius of the concave articular surface. Because of this incongruity no pressure will be transmitted in an area of the lunate surface or of the trochlear notch because of the defective contact. It follows that the cartilage-preserving stimulating pressure is also absent from this area. According to Pauwels, the magnitude and distribution of the stresses arising in the articulating surfaces may be determined from the varying density distribution of the subchondral bony tissue, as seen in x-rays. The density distribution of the subchondral bone at the ulnar socket shows clear basic parallels to the extent of the surface covered by joint cartilage. The relatively low density in the area of the notch is seen as being the result of lower stress, in accordance with the functional explanation of division of the cartilage surfaces. In photoelastic model experiments, the dependence of the degree of relative stress on the form of the articular surface is illustrated by means of the number of isochromes. Here, the distribution of density of the subchondral bony tissue corresponds to the local magnitude of stress in the corresponding model joint. Functional analysis of the tangential fiber layer of the joint cartilage at the femoral head and the elbow joint, shows basic agreement between the split line patterns and the trajectoral pattern, as described in articulating surfaces examined by Pauwels, Konermann and Molzberger...

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