舟骨环形征在腕月骨无菌性坏死X线片分期中的临床意义  

Clinical significance of scaphoid ring sign in Lichtman X ray staging of Kienbck's disease

作　　者：宫旭[1] 路来金[1] 王克利[1] 

机构地区：[1]吉林大学第一临床学院手外科,长春130021

出　　处：《中华手外科杂志》2004年第1期5-7,共3页Chinese Journal of Hand Surgery

基　　金：吉林省科技厅资助项目 ( 2 0 0 30 544 2 )

摘　　要：目的　阐明LichtmanⅢB 期中舟骨环形征的临床意义。方法　对 17例LichtmanⅢ期腕月骨无菌性坏死的术前X线平片 ,分别测量其腕高、腕高比值及桡舟角 ;以判断LichtmanⅢB 期腕关节是否较ⅢA 期进一步塌陷及舟骨是否进一步掌屈。同时 ,在 5侧新鲜腕关节标本上观察稳定腕舟骨的韧带的走行、起点和止点。结果　在LichtmanⅢA 期、ⅢB 期 ,腕高和腕高比值的测量值两者差异无显著意义 (P <0 0 5) ,而桡舟角的测量值ⅢB 期较ⅢA 期明显增大 (P <0 .0 5)。解剖发现 ,舟骨近极对腕舟骨起稳定作用的 3条韧带为桡舟头韧带、长桡月韧带及舟月骨间韧带。结论　舟骨环形征是舟骨旋转半脱位的X线片表现 ,代表舟骨的近极向背侧移位 。ObjectiveTo demonstrate the clinical significance of scaphoi d ring sign in Lichtman X ray staging of Kienbck's disease. Methods17 cases o f Lichtman's stage ⅢA and ⅢB Kienbck's disease were involved in the study. Preoperative X rays of these cases were studied to measure the carpal height, ca rpal height ratio and radioscaphoid angle. Comparison of these parameters was ma de between stage ⅢA and stage ⅢB cases. Carpal ligaments, which restrict mot ion of the scaphoid, were observed in 5 wrist specimens. Results There was no s ignificant difference in carpal height and carpal height ratio between stage Ⅲ A and stage ⅢB. The radioscaphoid angle was significantly larger in stage ⅢB than in stage ⅢA. There are three major ligaments that restrict the movement of the proximal pole of the scaphoid and hence stablize the scaphoid, i.e, radio scaphocapitate ligament, long radiolunate ligament and scapholunate interosseous ligament. ConclusionScaphoid ring sign represents rotary scap hoid subluxation . It indicates dorsal displacement of the proximal pole of the scaphoid, which s hould be surgically reduced and fixed to avoid advanced collapse of scapholunat e.

关 键 词：舟骨环形征 腕月骨无菌性坏死 X线片 分期 生物力学 

分 类 号：R816.8[医药卫生—放射医学]