Urban M A, Green D P, Aufdemorte T B
Hand Center of San Antonio, TX 78229.
J Hand Surg Am. 1993 Jul;18(4):669-74. doi: 10.1016/0363-5023(93)90316-U.
The proximal poles of five patients with presumed avascular necrosis of the scaphoid, mostly the result of nonunion, were analyzed histologically for true, pathologically confirmed avascular necrosis of bone. Each specimen was reviewed both qualitatively by an experienced bone pathologist and quantitatively with the use of a computerized image analysis system. Avascular necrosis was found to be variable from one specimen to another as well as within each specimen. Midcentral levels showed a statistically significant greater degree of avascular necrosis than either adjacent palmar or dorsal zones. Both viable and nonviable areas of avascular bone were found in an unpredictable, irregular (patchy) distribution, often in direct apposition to one another. It is apparent from this study that random biopsy alone cannot accurately predict the histologic status of the entire specimen; the clinician must rely on other methods to determine scaphoid viability.
对五例疑似舟骨缺血性坏死（大多由骨不连所致）患者的近端极进行了组织学分析，以确定是否存在真正的、经病理证实的骨缺血性坏死。每一份标本均由一位经验丰富的骨病理学家进行定性评估，并使用计算机图像分析系统进行定量分析。结果发现，各标本之间以及每个标本内部的缺血性坏死情况存在差异。标本中央中部区域的缺血性坏死程度在统计学上显著高于相邻的掌侧或背侧区域。缺血性骨的存活区和非存活区呈不可预测的不规则（斑片状）分布，且常常彼此紧邻。从这项研究可以明显看出，仅靠随机活检无法准确预测整个标本的组织学状况；临床医生必须依靠其他方法来确定舟骨的活力。
