Mirabello S C, Rosenthal D I, Smith R J
Department of Orthopaedics, Massachusetts General Hospital, Boston, 02114.
J Hand Surg Am. 1987 Nov;12(6):1049-54. doi: 10.1016/s0363-5023(87)80110-7.
Radiographic and clinical findings were reviewed in 50 patients with Kienböck's disease. In 40 patients the clinical and radiographic findings were complete enough to allow correlation of findings. Measurements were made from radiographs in an attempt to quantify the anatomic substrate of Kienböck's disease and to determine which radiographic measurements might be helpful in predicting the course and prognosis of the disease. The measurements included ulnar variance, radial slope, carpal index, carpal angle, combined cortical thickness, optical density, radial slant, scapho-lunate angle, lunate deformation quotient, and the radiographic stages modified from Stahl. These measurements were correlated with patient's history, age at onset of disease, range of motion, and grip strength. Relevant anatomic factors were ulnar variance and the radial slope. The best radiographic features for correlation with loss of motion and grip strength were the lunate deformation quotient and, to a lesser extent, the carpal index. None of the radiographic measurements were very strongly correlated with the clinical findings.
对50例月骨无菌性坏死患者的影像学和临床检查结果进行了回顾。40例患者的临床和影像学检查结果足够完整，能够进行结果相关性分析。通过X线片进行测量，试图量化月骨无菌性坏死的解剖学基础，并确定哪些影像学测量可能有助于预测疾病的病程和预后。测量内容包括尺骨变异、桡骨倾斜度、腕骨指数、腕骨角、皮质总厚度、骨密度、桡骨倾斜、舟月角、月骨变形系数以及根据施塔尔改良的影像学分期。这些测量结果与患者的病史、发病年龄、活动范围和握力进行了相关性分析。相关的解剖学因素是尺骨变异和桡骨倾斜度。与活动度和握力丧失相关性最好的影像学特征是月骨变形系数，其次是腕骨指数。没有一项影像学测量结果与临床检查结果有很强的相关性。
