月骨,三角骨周围性腕骨轴向崩解症

本文报告３例罕见的新鲜性月骨、三角骨周围性腕骨轴向崩解症。该症是在腕的三个纵向功能解剖的基础上，遭受了以纵向为主兼有侧向偏斜的暴力而发生的。它的基本病变是月骨及三角骨与桡骨关系正常，而其余腕骨皆在其三个纵轴间发生崩解，致使患腕在结构上出现了严重紊乱。在这种复杂的病变中月骨和舟骨起着关键的作用，亦是腕骨轴向崩解的基础。本病在受伤机制、临床诊断以及治疗方法上，均与月骨周围性脱位或创伤性腕骨轴向脱位有着明显的区别，因而本病应视为一种独立的病种。本组病例有桡偏型２例，采用切开复位；另１例为尺偏型，采用闭合手法而顺利复位。本组病例经７～３６个月的随访，结果表明患腕功能恢复良好。

Perilunatotriquetral Axial Burst Dislocation of Carpal Bones

Three cases of rarely seen fresh perilunatotriquetral axial burst dislocation of carpal bones are reported in this paper.Based on the anatomical three longitudinal functions of the wrist, this injury occurs under the longitudinal violences in combination with the lateral deviational one.The basic lesion is the burst dislocation between the three longitudinal axes of all the carpal bones but the lunate and triquetral bones are of normal relation to the radius.That results in the severe structural disorder of the wrist.It could be considered that the lunate and triquetral bones play a key part in this complex injury,being the basis of the axial burst dislocation of carpal bones.Therefore,this injury is significantly different from perilunate axial and traumatic axial dislocation of carpal bones in pathogenesis,clinical diagnosis and therapeutic methods.Therefore,the lesion should be regarded as an independent disease.In this series,2 cases of radio deviated type received open reduction,another one of ulno deviated type received successful closed manual reduction. A good recovery of the wrist function was obtained in three cases with 7-36 months of follow up.