Meade T D, Schneider L H, Cherry K
Department of Orthopaedic Surgery, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pa.
J Hand Surg Am. 1990 Nov;15(6):855-62. doi: 10.1016/0363-5023(90)90003-a.
Although scapholunate diastasis with rotatory subluxation of the scaphoid (stage I perilunar instability determined by Mayfield's classification) has been studied by several investigators, the exact contribution of the supporting ligaments is still being defined. We designed and executed an experimental study using six fresh-frozen cadaver specimens to demonstrate the radiographic changes seen on standard and stress wrist radiographs that correlate with the sequential sectioning of the scapholunate stabilizing ligaments. The radioscapho-lunate ligament, the palmar scapholunate interosseous ligament, the dorsal scapholunate interosseous ligament, and the radiocapitate ligament were sectioned sequentially to simulate a progressive wrist injury caused by an extension, intercarpal supination and ulnar deviation force. The results showed significant ligamentous injury must occur before commonly used radiographic limits are exceeded. The lateral scapholunate angle most closely reflected the progressive nature of this injury.
尽管舟月关节分离伴舟骨旋转半脱位（根据梅菲尔德分类法确定为I期月骨周围不稳定）已被多位研究者研究过，但支持韧带的确切作用仍有待明确。我们设计并实施了一项实验研究，使用六个新鲜冷冻尸体标本，以展示在标准腕关节X线片和应力位腕关节X线片上看到的与舟月稳定韧带的顺序切断相关的影像学变化。依次切断桡舟月韧带、掌侧舟月骨间韧带、背侧舟月骨间韧带和桡头韧带，以模拟由伸展、腕骨间旋后和尺偏力引起的渐进性腕关节损伤。结果表明，在超过常用的影像学界限之前，必须发生明显的韧带损伤。外侧舟月角最能准确反映这种损伤的渐进性。
