Fortems Y, de Smet L, Fabry G
Dpt of Orthopaedic Surgery, University Hospital Pellenberg, Belgium.
Ann Chir Main Memb Super. 1994;13(5):383-5; discussion 386. doi: 10.1016/s0753-9053(05)80079-1.
The growing precision of diagnostic techniques (MRI, arthrography, arthroscopy) and the consequent increase of the diagnosis of cartilaginous and ligamentous lesions of the wrist led us to undertake a detailed anatomical study of the carpus and to extend this study to the search for correlations between these lesions and the radio-ulnar index. Fifty one cadaveric wrists were dissected from an elderly population (mean age of 76 years). Cartilaginous lesions were found in two-thirds of radioulnar joints of the wrist with a marked predominance for the lunate bone (43%). The triangular cartilage of the fibrocartilaginous complex (TFCC) was perforated in 23 wrists (46%). We established a correlation between the radio-ulnar index and perforations of the TFCC (p < 0.05), as well as the thickness of this structure (p < 0.05). The relationship between age and rupture of intrinsic ligaments (p < 0.05), and the radio-ulnar index (p < 0.05) and age was also established. We present our figures, discuss the clinical implications, and draw the following conclusions from this study. 1) The carpus is a complex joint which is subject to age-related degeneration. 2) The large number of cartilaginous lesions observed in this study must be taken into account in the interpretation of MRI and the "over" precise results of arthroscopy.
诊断技术（MRI、关节造影、关节镜检查）的日益精确以及随之而来的腕部软骨和韧带损伤诊断率的提高，促使我们对手腕进行详细的解剖学研究，并将这项研究扩展到寻找这些损伤与桡尺指数之间的相关性。从老年人群（平均年龄76岁）中解剖了51例尸体手腕。在三分之二的腕部桡尺关节中发现了软骨损伤，其中月骨损伤最为明显（43%）。23例手腕（46%）的纤维软骨复合体三角软骨（TFCC）有穿孔。我们确定了桡尺指数与TFCC穿孔之间的相关性（p < 0.05），以及该结构的厚度之间的相关性（p < 0.05）。还确定了年龄与内在韧带断裂之间的关系（p < 0.05），以及桡尺指数（p < 0.05）与年龄之间的关系。我们展示了我们的数据，讨论了临床意义，并从这项研究中得出以下结论。1）腕关节是一个复杂的关节，容易发生与年龄相关的退变。2）在解释MRI和关节镜检查过于精确的结果时，必须考虑到本研究中观察到的大量软骨损伤。
