Kristensen S S, Thomassen E, Christensen F
J Hand Surg Br. 1986 Jun;11(2):258-60. doi: 10.1016/0266-7681(86)90275-5.
Forty four patients with forty seven wrists suffering from Kienböck's disease were re-examined. The mean observation time was 20.5 years. In all forty seven wrists the treatment had been immobilization. Using a standard X-ray projection, and a reliable method of ulnar variance measuring, the ulnar variance was determined by three observers independently. Comparing the result with the ulnar variance in normal wrists we found the so-called "ulnar minus variant" overrepresented in patients with Kienböck's disease. However, comparing X-rays taken at the time of diagnosis with X-rays at re-examination, we found in eight out of forty seven wrists that a subchondral bone formation in the distal radium opposite the lunate bone had taken place. This bone formation will tend to enhance the negative value of ulnar variance measurements, and suggests an explanation of the overrepresentation of "ulnar minus variants" in Kienböck's disease. Excluding these eight wrists from the material and comparing the mean ulnar variance value in the remaining thirty nine wrists with the mean value in normal wrists no statistical difference was shown. Based on these observations it seems unlikely that the "ulnar minus variant" has any bearing on the cause of Kienböck's disease.
对44例患有Kienböck病的47个腕关节患者进行了复查。平均观察时间为20.5年。在所有47个腕关节中，治疗方法均为固定。采用标准X线投照和可靠的尺骨变异测量方法，由三名观察者独立测定尺骨变异。将结果与正常腕关节的尺骨变异进行比较，我们发现在Kienböck病患者中所谓的“尺骨负变异”比例过高。然而，将诊断时拍摄的X线片与复查时的X线片进行比较，我们发现在47个腕关节中有8个在月骨相对的桡骨远端出现了软骨下骨形成。这种骨形成会倾向于增加尺骨变异测量的负值，并提示了Kienböck病中“尺骨负变异”比例过高的一种解释。将这8个腕关节排除在材料之外，并将其余39个腕关节的平均尺骨变异值与正常腕关节的平均值进行比较，未显示出统计学差异。基于这些观察结果，“尺骨负变异”似乎与Kienböck病的病因无关。
