Lee Donald H, Dickson Kent F, Bradley Edwin L
Division of Orthopedic Surgery, University of Alabama at Birmingham, 35294-3409, USA.
J Hand Surg Am. 2004 Jul;29(4):676-84. doi: 10.1016/j.jhsa.2004.02.011.
The purpose of this cadaveric wrist study was to determine the incidence and size of defects of the scapholunate interosseous ligament (SLIL), lunotriquetral interosseous ligament (LTIL), and triangular fibrocartilage (TFC) articular disc, and to determine their relationship to wrist arthrosis.
The status of the SLIL, LTIL, and the TFC articular disc was determined in 96 cadaveric wrists with an average age of 75 years (range, 61-92 y). The location and length of the SLIL and LTIL ligament disruptions and the site of ligament detachment were noted. Ligament disruptions were classified into 1 of 3 grades based on the size of the ligament disruption and the absence (grade 1 and 2 disruptions) or presence (grade 3 disruption) of wrist arthrosis. The location, size, and configuration of the TFC articular disc disruptions also were noted.
Disruptions of the SLIL were noted in 34 wrists (35%). There were 20 grade 1, 4 grade 2, and 10 grade 3 ligament disruptions. The average length of ligament disruption was 10.9 mm, or 40% of the length of the ligament. Twenty-four of 34 SLIL disruptions occurred without wrist arthrosis. Disruptions of the LTIL were noted in 47 wrists (49%). There were 23 grade 1, 10 grade 2, and 14 grade 3 ligament disruptions. The average length of ligament disruption was 7.6 mm, or 52% of the ligament length. Thirty-three of 47 LTIL disruptions occurred without wrist arthrosis. Disruptions of the TFC articular disc were noted in 58 wrists (60%). The most common patterns of disruption were either a linear defect at the radial attachment of the articular disc or a centrally located oval defect. Thirty-seven of the 58 TFC articular disc disruptions were noted in wrists without distal radioulnar joint (DRUJ) arthrosis.
There is a high incidence of SLIL, LTIL, and TFC articular disc disruptions in the cadaveric model. Large ligament and TFC articular disc disruptions without wrist arthrosis are very common.
本尸体手腕研究的目的是确定舟月骨间韧带（SLIL）、月三角骨间韧带（LTIL）和三角纤维软骨（TFC）关节盘损伤的发生率及大小，并确定它们与腕关节病的关系。
对96具平均年龄75岁（范围61 - 92岁）的尸体手腕，确定SLIL、LTIL和TFC关节盘的状况。记录SLIL和LTIL韧带断裂的位置和长度以及韧带附着点的位置。根据韧带断裂的大小以及腕关节病的有无（1级和2级断裂无腕关节病，3级断裂有腕关节病），将韧带断裂分为3级中的1级。还记录了TFC关节盘损伤的位置、大小和形态。
在34只手腕（35%）中发现SLIL断裂。有20例1级、4例2级和10例3级韧带断裂。韧带断裂的平均长度为10.9毫米，占韧带长度的40%。34例SLIL断裂中有24例发生时无腕关节病。在47只手腕（49%）中发现LTIL断裂。有23例1级、10例2级和14例3级韧带断裂。韧带断裂的平均长度为7.6毫米，占韧带长度的52%。47例LTIL断裂中有33例发生时无腕关节病。在58只手腕（60%）中发现TFC关节盘损伤。最常见的损伤模式是关节盘桡侧附着处的线性缺损或中央的椭圆形缺损。58例TFC关节盘损伤中有37例发生在无下尺桡关节（DRUJ）关节病的手腕中。
在尸体模型中，SLIL、LTIL和TFC关节盘损伤的发生率很高。无腕关节病的大韧带和TFC关节盘损伤非常常见。
