Kerschbaumer F, Bauer R
Orthopade. 1986 Apr;15(2):121-30.
The most frequent aseptic necrosis in the carpal area is Kienböck's disease, followed by necrosis of the scaphoid and capitate. Necrosis of carpal bones are seen after different conditions as chronic traumatism, cerebral palsy, chemotherapy, as well as deficient vascularisation of the carpus. Varietys of the wrist joint anatomy may contribute to development of Kienböck's disease. The natural course of the disease shows progressive necrosis and bone destruction in adults. However the clinical symptomatology may show a higher degree of variation. Prevention of carpal dissociation seems to be important. Early surgery by vascularisation techniques and retention of the necrotic bone are indicated. In stages III and IV with collapsing deformity, resection-interposition arthroplasty using autologous material, or silastic spacers, have proven to be successful.
腕部最常见的无菌性坏死是月骨无菌性坏死，其次是舟骨和头状骨坏死。腕骨坏死可见于多种情况，如慢性创伤、脑瘫、化疗以及腕部血管供应不足。腕关节解剖结构的多样性可能促使月骨无菌性坏死的发生。在成人中，该病的自然病程表现为进行性坏死和骨质破坏。然而，临床症状可能有较高的变异性。预防腕骨分离似乎很重要。建议通过血管化技术进行早期手术并保留坏死骨。在出现塌陷畸形的Ⅲ期和Ⅳ期，使用自体材料或硅橡胶间隔物进行切除-植入关节成形术已被证明是成功的。
