Black D M, Watson H K, Vender M I
Connecticut Combined Hand Service: Hartford Hospital, University of Connecticut.
Clin Orthop Relat Res. 1987 Nov(224):205-9.
Ten of 64 patients reviewed with scaphoid nonunion were found to have scapholunate gaps (SLG). A roentgenographic study of the entire group who were symptomatic, but had no prior surgery, showed the SLG. The SLG indicated severe ligamentous injury and instability, and was always associated with the presence of Doral Intercalated Segment Instability (DISI) and an increased scapholunate angle. Instability was progressive and associated with the early onset of arthritis. In the entire group of nonunions, high frequency of arthritis occurred with a predictable sequence of radioscaphoid and midcarpal degenerative changes. Terminal wrist arthritis in scaphoid nonunion developed in the scapholunate articulation, as a manifestation of rotary subluxation of the distal scaphoid fragment.
在接受舟骨不愈合复查的64例患者中，有10例被发现存在舟月间隙（SLG）。对所有有症状但未接受过手术的患者进行的X线研究显示了舟月间隙。舟月间隙表明存在严重的韧带损伤和不稳定，并且总是与背侧插入节段不稳定（DISI）以及舟月角增大相关。不稳定是进行性的，并且与关节炎的早期发作有关。在整个不愈合组中，关节炎的发生率很高，伴有桡舟关节和腕中关节退变改变的可预测序列。舟骨不愈合中的终末期腕关节炎发生在舟月关节，表现为舟骨远端骨折块的旋转半脱位。
