Mohan Arvind, Knight Richard, Ismail Hiba, Trail Ian A
Croydon University Hospital NHS Trust, London, England.
Upper Limb Unit, Wrightington Hospital, Lancashire, England.
J Wrist Surg. 2020 Feb;9(1):39-43. doi: 10.1055/s-0039-1688993. Epub 2019 Dec 11.
Carpal height ratio and ulnar variance on plain X-ray were measured and compared to the width/height ratio of the lunate as measured on a computed tomography (CT) scan in 50 patients with Kienböck's disease. Width/height ratio of the lunate was also measured in a series of 50 controls. No correlation between ulnar variance and fractures was found. Conversely, the correlation between carpal height ratio on X-ray and width/height ratio on a CT scan was statistically significant. Similarly, the correlation between ulnar variance and width/height ratio was statistically significant. We have concluded that width/height ratio while correlating with carpal height is a better measure of lunate collapse. It also appeared that lunate collapse precedes carpal collapse, specifically most if not all lunates have collapsed prior to reduction in carpal height ratio. Finally, while we are unable to conclude the level at which the width/height ratio of lunate becomes unreconstructable, it does appear that in all Litchman stage 3b and most if not all of 3a the shape of the lunate has altered significantly.
对50例Kienböck病患者进行了腕关节正位X线片测量腕高比和尺骨变异，并与计算机断层扫描（CT）测量的月骨宽高比进行比较。还对50例对照者测量了月骨宽高比。未发现尺骨变异与骨折之间存在相关性。相反，X线片上的腕高比与CT扫描上的宽高比之间的相关性具有统计学意义。同样，尺骨变异与宽高比之间的相关性也具有统计学意义。我们得出结论，宽高比虽然与腕高相关，但它是月骨塌陷的更好指标。还发现月骨塌陷先于腕关节塌陷，特别是大多数（如果不是全部）月骨在腕高比降低之前就已经塌陷。最后，虽然我们无法确定月骨宽高比变得无法重建的水平，但在所有Litchman 3b期以及大多数（如果不是全部）3a期，月骨的形状确实发生了显著改变。
