Iwasaki N, Minami A, Miyazawa T, Kaneda K
Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
J Hand Surg Am. 2000 Sep;25(5):870-6. doi: 10.1053/jhsu.2000.16353.
The pattern of subchondral bone density has been considered to reflect the stress distribution that occurs under physiologic loading conditions. To determine the force distribution through the wrist joint with Kienböck's disease in living subjects, we applied a computed tomography osteoabsorptiometry and investigated the subchondral bone density pattern across the radio-carpal joint of 6 normal subjects and 10 patients suffering from Kienböck's disease (Lichtman's stage IIIA, 5 patients; stage IIIB, 5 patients). A single density maximum was found in each scaphoid and lunate fossa in all normal subjects. Among the subjects with Kienböck's disease, the current analysis demonstrated that the density maximum area significantly increased in the scaphoid fossa and decreased in the lunate fossa from stage IIIA to IIIB group. These findings indicate that the load is shifted away from the lunate to the scaphoid with the progression of Kienböck's disease in living subjects.
软骨下骨密度模式被认为可反映生理负荷条件下发生的应力分布。为了确定患有月骨无菌性坏死的活体受试者腕关节的力分布，我们应用了计算机断层扫描骨吸收测量法，并研究了6名正常受试者和10名患有月骨无菌性坏死患者（ Lichtman IIIA期，5例；IIIB期，5例）桡腕关节的软骨下骨密度模式。在所有正常受试者的每个舟骨和月骨窝中均发现单一密度最大值。在患有月骨无菌性坏死的受试者中，当前分析表明，从IIIA期到IIIB期组，舟骨窝的密度最大区域显著增加，而月骨窝的密度最大区域则减少。这些发现表明，在活体受试者中，随着月骨无菌性坏死病情的进展，负荷从月骨转移至舟骨。
