Bourne M H, Linscheid R L, Dobyns J H
Department of Orthopedics, Mayo Clinic, Rochester, Minn 55905.
J Hand Surg Am. 1991 May;16(3):460-4. doi: 10.1016/0363-5023(91)90014-3.
Six men had concurrent scapholunate dissociation and Kienböck's disease, a finding suggestive of a common cause. Five patients attributed the onset of wrist pain to a single traumatic event. Three had x-ray evidence of scapholunate dissociation before the onset of lunate osteonecrosis. Biomechanical factors that may be of significance are ulnar minus variance, lesser compliance of the triangular fibrocartilage, ulnar translation of the carpus at impact with shear fracture through the lunate, and disruption of the scapholunate interosseous membrane occurring under similar stress. Lunate osteonecrosis may depend on a susceptible vascular pattern or intraosseous injury or both. The development of lunatomalacia complicates an already unstable wrist. Treatment options vary according to the clinical stages of each condition, although contrasting treatments have not established optimal care.
6名男性同时患有舟月骨分离和月骨无菌性坏死，这一发现提示存在共同病因。5例患者将腕部疼痛的发作归因于单一创伤事件。3例在月骨骨坏死发作前有舟月骨分离的X线证据。可能具有重要意义的生物力学因素包括尺骨负变异、三角纤维软骨顺应性降低、腕骨在撞击时向尺侧移位并通过月骨发生剪切骨折，以及在类似应力下舟月骨间韧带断裂。月骨骨坏死可能取决于易患的血管模式或骨内损伤或两者皆有。月骨软化的发展使本已不稳定的腕部情况更为复杂。治疗方案根据每种疾病的临床阶段而有所不同，尽管不同的治疗方法尚未确定最佳治疗方案。
