Joji S, Mizuseki T, Katayama S, Tsuge K, Ikuta Y
Department of Orthopaedic Surgery, Hiroshima University School of Medicine, Japan.
J Hand Surg Br. 1993 Jun;18(3):294-8. doi: 10.1016/0266-7681(93)90044-g.
Examination of 110 patients with cerebral palsy revealed a diagnosis of Kienböck's disease in six wrists in five cases. All had cerebral palsy of the mixed type with athetosis and high muscle tone. It is considered that the increased prevalence of Kienböck's disease in these cases was attributable to repeated minor trauma to the lunate from childhood due to high muscle tone across the wrist joint, together with negative ulnar variance. The high prevalence of Kienböck's disease observed in patients with cerebral palsy strongly suggests that repeated minor trauma together with negative ulnar variance is also the cause of Kienböck's disease in normal individuals.
对110例脑瘫患者进行检查后发现，5例患者的6只手腕被诊断为月骨无菌性坏死。所有患者均为混合型脑瘫，伴有手足徐动症和高肌张力。据认为，这些病例中月骨无菌性坏死患病率增加的原因是，由于腕关节处的高肌张力，自儿童期起月骨就反复受到轻微创伤，同时伴有尺骨负变异。在脑瘫患者中观察到的月骨无菌性坏死高患病率有力地表明，反复轻微创伤与尺骨负变异也是正常个体患月骨无菌性坏死的原因。
