Milliez P Y, Kinh Kha H, Allieu Y, Thomine J M
Service Orthopédie, Hôpital Charles Nicolle, Rouen, France.
Int Orthop. 1991;15(2):85-94. doi: 10.1007/BF00179703.
The authors report 3 cases of idiopathic avascular necrosis of the capitate and review them together with published reports of 16 further cases. The patients are normally young and the diagnosis delayed. The radiographs may demonstrate an eggshell appearance, a sequestrum, marked sclerosis, or cystic changes. A classification is proposed based on the portion of the bone involved. Early osteoarthritic changes occur and carpal instability may develop. It is suggested that there are features in the blood supply which may be significant. Treatment is by operation, involving either excision of the capitate with replacement with a prosthetic spacer, or else by arthrodesis.
作者报告了3例特发性头状骨缺血性坏死病例,并结合另外16例已发表报告对其进行了回顾。患者通常较为年轻,诊断往往延迟。X线片可能显示蛋壳样外观、死骨、明显硬化或囊性改变。根据受累骨的部位提出了一种分类方法。早期会出现骨关节炎改变,可能发展为腕骨不稳。提示血供方面存在一些可能具有重要意义的特征。治疗方法为手术,包括切除头状骨并用假体间隔物置换,或进行关节融合术。