Werner F W, Palmer A K
Department of Orthopedic Surgery, State University of New York Health Science Center, Syracuse.
Hand Clin. 1993 Aug;9(3):431-43.
Operative procedures used to treat Kienböck's disease have been biomechanically evaluated experimentally. We have shown that joint leveling procedures, such as radial shortening and ulnar lengthening, experimentally unload the ulna and the radial lunate fossa. For wrists with neutral ulnar variance, a lateral opening or medial closing radial wedge procedure unloads the radial lunate fossa. Scapho-trapezio-trapezoidal fusion and scapho-capitate fusion also unload the radial lunate fossa but at the expense of loading the adjacent joints. Neither a capitate-hamate fusion nor a carpal tunnel release alter the radial ulnar carpal joint loading.
用于治疗月骨无菌性坏死的手术操作已通过实验进行了生物力学评估。我们已经表明，关节平衡手术，如桡骨缩短和尺骨延长，在实验中可减轻尺骨和桡骨月骨窝的负荷。对于尺骨变异为中性的腕关节，外侧开口或内侧闭合桡骨楔形截骨手术可减轻桡骨月骨窝的负荷。舟状骨-大多角骨-小多角骨融合术和舟状骨-头状骨融合术也可减轻桡骨月骨窝的负荷，但代价是增加了相邻关节的负荷。头状骨-钩骨融合术和腕管松解术均不会改变桡尺腕关节的负荷。
