Peh W C, Gilula L A
Department of Diagnostic Radiology, University of Hong Kong, Queen Mary Hospital, Hong Kong.
J Hand Surg Am. 1996 Jul;21(4):561-6. doi: 10.1016/S0363-5023(96)80004-9.
The hypotheses that carpal arcs normally break in radial and ulnar deviation and that they remain intact in the neutral position were tested. Wrist instability series of 100 asymptomatic wrists were reviewed. Three carpal arcs were drawn on posteroanterior (prone) and anteroposterior (supine) x-ray films in neutral and radial- and ulnar-deviated positions, and any proximal-distal arc step-off was measured. On posteroanterior radial deviation at the lunatriquetral joint, arc I was disrupted in 80 and arc II disrupted in 78 cases, while at the scapholunate joint, arc II was disrupted in 10 cases. Similar findings were detected on anteroposterior views. In ulnar deviation, arc II was disrupted at the scapholunate joint in 30 posteroanterior and 12 anteroposterior cases, respectively. With 4 exceptions, arcs I and II were normal in neutral anteroposterior and posteroanterior positions. Six of 20 wrists with a type II lunate had arc II disruption. Arc III was intact in all positions. As radiographic carpal arcs normally disrupt with radial and ulnar deviation, caution in interpretation of arcs I and II and scapholunate joint width should be exercised when the wrist is not strictly neutral in position.
对腕骨弧线在桡偏和尺偏时通常会中断而在中立位时保持完整这一假说进行了检验。回顾了100例无症状手腕的腕关节不稳定系列情况。在中立位以及桡偏和尺偏位的后前位（俯卧位）和前后位（仰卧位）X线片上绘制三条腕骨弧线，并测量任何近端-远端弧线的台阶状错位。在后前位桡偏时，在月三角关节处，80例I弧线中断，78例II弧线中断；而在舟月关节处，10例II弧线中断。在前后位片上也检测到类似结果。在尺偏时，在后前位片上30例、前后位片上12例在舟月关节处II弧线中断。除4例例外情况外，在中立位的前后位和后前位时I弧线和II弧线均正常。在20例II型月骨的手腕中，6例存在II弧线中断。III弧线在所有位置均完整。由于放射影像学上的腕骨弧线在桡偏和尺偏时通常会中断，因此当手腕位置并非严格中立时，在解读I弧线和II弧线以及舟月关节宽度时应谨慎。
