Trumble T, Glisson R R, Seaber A V, Urbaniak J R
J Hand Surg Am. 1986 Jan;11(1):88-93. doi: 10.1016/s0363-5023(86)80111-3.
Reduction of lunate compression is thought to promote revascularization of the lunate in patients with Kienböck's disease. The decompressing abilities of ulnar lengthening, radial shortening, capitate-hamate fusion, and scaphoid-trapezium-trapezoid (STT) fusion were examined in axially loaded, whole arm specimens. Lunate strain was monitored by electronic strain gauges and found to be proportional to the axial load borne by the bone. The STT fusions and the procedures to alter relative radial and ulnar length were successful in relieving lunate loading throughout a functional range of wrist motion and forearm rotation, but the capitate-hamate fusion was ineffective. Only the STT fusion resulted in a significant decrease in wrist range of motion. Incremental ulnar lengthening and radial shortening revealed that approximately 2 mm of length change maximizes lunate decompression without greatly increasing the risk of disorders of the distal radioulnar joint and ulnocarpal impingement.
月骨减压被认为可促进月骨无菌性坏死患者月骨的血管再生。在轴向加载的全臂标本中，检测了尺骨延长、桡骨缩短、头状骨-钩骨融合和舟状骨-大多角骨-小多角骨（STT）融合的减压能力。通过电子应变片监测月骨应变，发现其与骨骼承受的轴向负荷成正比。STT融合以及改变桡尺相对长度的手术在整个腕关节运动和前臂旋转功能范围内成功减轻了月骨负荷，但头状骨-钩骨融合无效。只有STT融合导致腕关节活动范围显著减小。逐步进行尺骨延长和桡骨缩短显示，大约2毫米的长度变化可使月骨减压最大化，而不会大幅增加远侧桡尺关节紊乱和尺腕撞击的风险。
