腕月骨无菌性坏死的病因学研究

Study on etiology of lunate avascular necrosis

目的 探讨月骨无菌性坏死的病因。方法 通过对腕关节机能解剖、月骨内微组织结构及腕关节X线影像学的研究 ,阐明月骨无菌性坏死的致病因素。结果 (1)月骨的血运有 2 0 %由掌侧或背侧单一滋养血管供血或主要供血 ,这类单侧主干型血供的月骨易发生无菌性坏死。 (2 )月骨内骨小梁的走行方向由远端行向近端 ,相互平行 ,这与月骨的应力传导方向相一致。 (3)月骨内微血管中央段的数量多而小 ,掌侧段血管稍粗大 ,血管面积及其与骨截面积比值最大。 (4)病变组月骨呈掌屈畸形。

Objective To discuss the etiology of lunate avascular necrosis. Methods After the study of functional anatomy of wrist joint and intra-lunate micro-structure and wrist X-ray, we put forward the factors contributing to lunate avascular necrosis. Results (1) 20% lunate was supplied by single either volar or dorsal blood vessels, completely or mainly,which predisposed to Kienb*ick's disease. (2) Lunate trabeculae correllates with conduction of stress from distal to proximal end. (3) Capillaries in central part is excessive in amount and small in diameter, and capillaries in palmar part is larger than in central part,in which the rate of blood vessels areas to bone sections is the largest, demonstrating that blood supply in volar part is predominant. (4) There was volar flexion deformity of the lunate in abnormal group. Conclusions Kienb*ick's disease is caused by intrinsic and extrinsic factors associntedi with the lunate.