Yamaguchi S, Viegas S F, Patterson R M
Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston 77555-0892, USA.
J Hand Surg Am. 1998 Jul;23(4):600-6. doi: 10.1016/S0363-5023(98)80044-0.
Eighty embalmed cadaver wrists (40 right and 40 left, 55 male and 25 female, aged 36 to 93 years [average age, 72.5 years]) were dissected to assess the anatomy of the pisotriquetral joint and the location of degenerative changes. The patterns of degenerative changes were classified into five types: type 1, central (8.8%); type 2, peripheral (38.8%); type 3, fan-shaped (13.8%); type 4, mixed (combination of > or =1 of types 1, 2, and/or 3; 10.0%); and type 5, total (12.5%). There was no cartilagenous change in 16.2% of the pisoform and 13.7% of the triquetrum. Degenerative changes (exposed subchondral bone and chondromalacia) on the articular surface of the pisiform were present in 83.3% of the wrists and on the triquetrum in 86.3% of the wrists. Degenerative changes were most commonly of the type 2 pattern (peripheral), with change located most commonly in the distal, distal-radial, and radial aspects of the pisiform and triquetrum. The ligamentous anatomy was categorized into 3 different types: type A, pisohamate and pisometacarpal ligaments inserted on the palmar distal aspect of the pisiform (52.5%); type B, pisohamate ligament inserted on the radial side of the pisiform and pisometacarpal ligament inserted on the palmar side of the pisiform (41.3%); and type C, type B anatomy with an additional ligamentous slip between the pisometacarpal ligament and the distal aspect of the hook of the hamate (6.2%).
解剖了80具经过防腐处理的尸体手腕（40只右手和40只左手，55例男性和25例女性，年龄36至93岁[平均年龄72.5岁]），以评估豌豆三角骨间关节的解剖结构及退变改变的部位。退变改变的模式分为五种类型：1型，中央型（8.8%）；2型，周围型（38.8%）；3型，扇形（13.8%）；4型，混合型（1型、2型和/或3型中≥1种类型的组合；10.0%）；5型，全关节型（12.5%）。16.2%的豌豆骨和13.7%的三角骨无软骨改变。豌豆骨关节面的退变改变（软骨下骨暴露和软骨软化）在83.3%的手腕中存在，三角骨在86.3%的手腕中存在。退变改变最常见的是2型模式（周围型），改变最常位于豌豆骨和三角骨的远侧、桡侧远端和桡侧。韧带解剖结构分为3种不同类型：A型，豌豆钩骨韧带和豌豆掌骨韧带附着于豌豆骨掌侧远端（52.5%）；B型，豌豆钩骨韧带附着于豌豆骨桡侧，豌豆掌骨韧带附着于豌豆骨掌侧（41.3%）；C型，B型解剖结构，在豌豆掌骨韧带和钩骨钩远端之间有一条额外的韧带束（6.2%）。
