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双侧二分月骨误诊为腕骨骨折:病例报告及文献复习。

Bilateral bipartite lunate misdiagnosed as carpal fracture: a case report and brief review of literature.

机构信息

Hand Surgery and Microsurgery Department, Christine M. Kleinert Institute, 225 Abraham Flexner Way, Suite 850, Louisville, KY, 40202, USA.

Departamento de Ortopedia y Traumatología, Universidad de Monterrey, División de Ciencias de La Salud, Hospital Christus Muguerza Alta Especialidad, Miguel Hidalgo 2525, Obispado, Monterrey, Nuevo León, 64060, México.

出版信息

Surg Radiol Anat. 2021 May;43(5):771-774. doi: 10.1007/s00276-020-02628-y. Epub 2021 Jan 2.

Abstract

Bilateral bipartite lunate is a very rare congenital anomaly of the lunate. A 36-year-old military European male was referred to our service diagnosed with a lunate fracture. Symptoms began 3 months before our encounter, after falling on his outstretched left hand. The patient was misdiagnosed with a lunate fracture, therefore treated with a cast and then transitioned to a removable splint over 2 months in total; When the patient presented to our facility, on physical examination, he referred pain over the dorso-ulnar side of the wrist, especially the ulnar snuff. Tenderness to palpation over the fovea and positive triangular fibrocartilage complex axial compression test was encountered. Bilateral wrist X-rays were taken, and a diagnosis of bilateral bipartite lunate was made by our team. The patient was treated for ulnar-sided wrist pain with steroid injection and physical rehabilitation. A literature review on bipartite lunate was conducted, and cases share three basic common features: unilateral involvement, incidentally diagnosed after a traumatic event, and absence of positive clinical findings related to the bipartition.

摘要

双侧二分月骨是月骨非常罕见的先天性异常。一位 36 岁的欧洲男性军人因月骨骨折被转诊至我科。症状始于 3 个月前,当时他的左手伸出后摔倒。患者最初被误诊为月骨骨折,因此接受了石膏固定,总共持续了 2 个月,然后过渡到可移动夹板;当患者到我院就诊时,体格检查发现他腕部背侧-尺侧疼痛,尤其是尺侧鼻烟窝处疼痛。触诊发现月骨窝处压痛,且三角纤维软骨复合体轴向压缩试验阳性。拍摄双侧腕关节 X 线片,我们团队诊断为双侧二分月骨。患者因尺侧腕部疼痛接受了类固醇注射和物理康复治疗。我们对二分月骨进行了文献复习,发现病例有三个基本共同特征:单侧受累、创伤事件后偶然诊断、与二分体无关的阳性临床发现缺失。

相似文献

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Symptomatic bilateral bipartite lunate: a case report.症状性双侧二分月骨:一例报告
J Hand Surg Eur Vol. 2015 Jun;40(5):539-40. doi: 10.1177/1753193413508513. Epub 2013 Oct 25.
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Bilateral bipartite lunate: a case report.双侧二分月骨:一例报告。
J Hand Surg Am. 2002 Mar;27(2):355-9. doi: 10.1053/jhsu.2002.32082.
10

本文引用的文献

3
Anomalous Carpal Bones.腕骨异常。
J Anat. 1923 Jul;57(Pt 4):378-9.
4
Lunate morphology.月骨形态
J Biomech. 2002 Nov;35(11):1451-7. doi: 10.1016/s0021-9290(02)00178-1.
6
[Bipartite lunate bone].[二分月骨]
Z Orthop Ihre Grenzgeb. 1983 Mar-Apr;121(2):192-5. doi: 10.1055/s-2008-1051339.
7
Congenital bipartite carpal lunate. A case report.先天性二分月骨。病例报告。
Am J Sports Med. 1978 Nov-Dec;6(6):405-8. doi: 10.1177/036354657800600619.

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