THE PATCHY CONFIGURATION OF SCAPHOID AVASCULAR NECROSIS

被引:29
作者
URBAN, MA [1 ]
GREEN, DP [1 ]
AUFDEMORTE, TB [1 ]
机构
[1] HAND CTR SAN ANTONIO,7940 FLOYD CURL DR,SUITE 900,SAN ANTONIO,TX 78229
来源
JOURNAL OF HAND SURGERY-AMERICAN VOLUME | 1993年 / 18A卷 / 04期
关键词
D O I
10.1016/0363-5023(93)90316-U
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
The proximal Poles of five patients with presumed avascular necrosis of the scaphoid, mostly the result of nonunion, were analyzed histologically for true, pathologically confirmed avascular necrosis of bone. Each specimen was reviewed both qualitatively by an experienced bone pathologist and quantitatively with the use of a computerized image analysis system. Avascular necrosis was found to be variable from one specimen to another as well as within each specimen. Midcentral levels showed a statistically significant greater degree of avascular necrosis than either adjacent palmar or dorsal zones. Both viable and nonviable areas of avascular bone were found in an unpredictable, irregular (patchy) distribution, often in direct apposition to one another. It is apparent from this study that random biopsy alone cannot accurately predict the histologic status of the entire specimen; the clinician must rely on other methods to determine scaphoid viability.
引用
收藏
页码:669 / 674
页数:6
相关论文
共 22 条
[1]  
Russe, Fracture of the carpal navicular, J Bone Joint Surg Am, 42 A, pp. 759-768, (1960)
[2]  
Stark, Rickard, Zemel, Ashworth, Treatment of ununited fractures of the scaphoid by iliac bone grafts and Kirschner-wire fixation, J Bone Joint Surg, 70 A, pp. 982-991, (1988)
[3]  
Cooney, Dobyns, Linscheid, Nonunion of the scaphoid: analysis of the results from bone grafting, J Hand Surg, 5, pp. 343-354, (1980)
[4]  
Cooney, Linscheid, Dobyns, Scaphoid fractures: problems associated with nonunion and avascular necrosis, Orthop Clin North Am, 15, pp. 381-391, (1984)
[5]  
Szabo, Manske, Displaced fractures of the scaphoid, Clin Orthop Relat Res, 230, pp. 30-38, (1988)
[6]  
Trumble, Avascular necrosis after scaphoid fracture: a correlation of magnetic resonance imaging and histology, J Hand Surg, 15 A, pp. 557-564, (1990)
[7]  
Bellemore, Cummine, The role of bone scans in the assessment of prognosis in acute scaphoid fractures, J Bone Joint Surg, 65 B, (1983)
[8]  
Perlik, Guilford, Magnetic resonance imaging to assess vascularity of scaphoid nonunions, J Hand Surg, 16 A, pp. 479-484, (1991)
[9]  
Renus, Conway, Totty, Et al., Carpal avascular necrosis: MR imaging, Radiology, 160, pp. 689-693, (1986)
[10]  
Green, The effect of avascular necrosis on Russe bone grafting for scaphoid nonunion, J Hand Surg, 10 A, pp. 597-605, (1985)