Stahl S, Lotter O, Santos Stahl A, Meisner C, Luz O, Pfau M, Schaller H-E
Klinik für Hand-, Plastische-, Rekonstruktive und Verbrennungschirurgie, BG-Unfallklinik Tübingen, Schnarrenbergstr. 95, 72076 Tübingen, Deutschland.
Orthopade. 2012 Jan;41(1):66-72. doi: 10.1007/s00132-011-1803-9.
Kienböck's disease (KD) leads to collapse of the lunate bone with severe consequences for the wrist function which for some patients may result in occupational invalidity. The many synonyms of KD (aseptic necrosis or avascular necrosis) insinuate that the true etiopathology remains poorly understood. This reviews aims at exploring the level of evidence which brought forward the different hypotheses on the origin of KD. The widespread theories about the origin were formed about 100 years ago but a specific therapy is still not within reach. Although the cause of the disease remains essentially unknown it is officially recognized as an occupational disease in Germany. Empirical attempts to explain the etiopathology are based on compression of the lunate, impaired vascularity through vibration exposition, fracture and dislocation of the lunate from the radiolunate fossa. The level of evidence urges a cautious interpretation of currently discussed hypotheses on the etiology of KD.
月骨无菌性坏死（KD）会导致月骨塌陷，严重影响腕关节功能，对一些患者而言可能导致职业残疾。KD有许多同义词（无菌性坏死或缺血性坏死），这意味着其真正的病因病理仍未得到充分理解。本综述旨在探究为KD起源提出不同假说的证据水平。关于起源的广泛理论大约在100年前形成，但仍未找到特效疗法。尽管该病病因基本不明，但在德国它被官方认定为职业病。对病因病理的经验性解释基于月骨受压、因接触振动导致血管受损、月骨从桡月关节窝骨折和脱位。证据水平促使我们对当前讨论的KD病因假说进行谨慎解读。
