Zusammenfassung
Das Kahnbein hat klinisch eine so große Bedeutung für das Handgelenk, dass die in der Literatur deutlich unterrepräsentierte Anatomie und Biomechanik des Kahnbeins genauer und nach aktuellen Erkenntnissen dargestellt werden soll. Die Herkunft des Namens und die Geschichte früherer Namen für das Os scaphoideum, wie das Kahnbein seit 1955 offiziell heißt, sowie die interessante Phylogenese und die Ontogenese werden dargestellt. Der anatomische Aufbau, die Blutversorgung, die Bandverbindungen und die Biomechanik des Kahnbeins werden detailliert beschrieben.
Abstract
The scaphoid is biomechanically and clinically of great importance for function of the wrist. In the literature, its anatomy and biomechanics are clearly underrepresented as well as underestimated. In the following review the scaphoid will be presented in more detail, according to recent information and findings. Not only will the origin of the name and the history of previous names, such as cotyloid or navicular, be introduced, but also for the first time in medical literature the significant phylogeny and ontogeny of the scaphoid will be shown. Moreover, the clinically very important blood supply, the ligaments of the scaphoid and relevant biomechanical details will be described.
Literatur
Ahrens C, Unglaub F, Hahn P, Leclère FM, Spies CK (2015) Symptomatische karpale Koalition zwischen Os scaphoideum, Os trapezium und Os trapezoideum bei ipsilateraler Daumenhypoplasie. Handchir Mikrochir Plast Chir 47:70–72
Belsole RJ, Hilbelink DR, Llewellyn JA et al (1991) Carpal orientation from computed reference axes. J Hand Surg Am 16(A):82–90. doi:10.1016/s0363-5023(10)80018-8
Berger RA, Imeada T, Berglund L, An K‑N (1999) Constraint and material prperties of the subregions of the scapholunate interosseous ligament. J Hand Surg Am 24(A):953–962. doi:10.1053/jhsu.1999.0953
Berger RA (2001) The anatomy of the scaphoid. Hand Clin 17:525–532
Bettinger PC, Linscheid RL, Berger RA, Cooney WP III, An KN (1999) An anatomic study of the stabilizing ligaments of the trapezium and trapeziometacarpal joint. J Hand Surg Am 24(A):786–798. doi:10.1053/jhsu.1999.0786
Bickert B, Kremer T, Kneser U (2014) Operative Therapie der Skaphoidpseudarthrose. Obere Extrem 9:271–275
Blevens AD, Light TR, Jablonsky WS et al (1989) Radiocarpal articular contact characteristics with scaphoid instability. J Hand Surg Am 14:781–790. doi:10.1016/s0363-5023(89)80076-0
Bogart FB (1932) Variations of the bones of the wrist. AJR Am J Roentgenol 28:638–646
Botte MJ, Mortensen WW, Gelberman RH, Rhoades CE, Gellman H (1988) Internal vascularity of the scaphoid in cadavers after insertion of the Herbert screw. J Hand Surg Am 13(A):216–220. doi:10.1016/s0363-5023(88)80051-0
Buijze GA, Lozano-Calderon SA, Strackee SD, Blankevoort L, Jupiter JB (2011) Osseous and ligamentous scaphoid anatomy: Part I. A systematic literature review highlighting controversies. J Hand Surg Am 36(A):1926–1935. doi:10.1016/j.jhsa.2011.09.012
Buijze GA, Dvinskikh NA, Strackee SD, Streekstra GJ, Blankevoort L (2011) Osseous and ligamentous scaphoid anatomy: Part II: Evaluation of ligament morphology using three-dimential anatomic imaging. J Hand Surg Am 36(A):1936–1943. doi:10.1016/j.jhsa.2011.09.016
Ceri N, Korman E, Gunal I, Tetik S (2004) The morphological and morphometric features of the scaphoid. J Hand Surg Eur Vol 29(B):393–398. doi:10.1016/j.jhsb.2004.02.006
Cihak R (1972) Ontogenesis of the skeleton and intrinsic muscles of the human hand and foot. Ergebn Anat Entwgsch 1(46):1–194
Crisco JJ, Coburn JC, Moore DC, Akelman E, Weiss AP, Wolfe SW (2005) In vivo radiocarpal kinematics and the dart thrower’s motion. J Bone Joint Surg Am 87(A):2729–2740. doi:10.2106/jbjs.d.03058
Doman AN, Marcus NW (1990) Congenital bipartite scaphoid. J Hand Surg Am 15(A):869–873. doi:10.1016/0363-5023(90)90005-c
Dubey PP, Chahan NK, Siddiqui MS (2011) Vascular foramina of the scaphoid and its clinical implications. Biomed Res 22:4–6
Garcia-Elias M, Cooney WP, An KN et al (1989) Wrist kinematics after limited intercarpal arthrodesis. J Hand Surg Am 14(A):791–799. doi:10.1016/s0363-5023(89)80077-2
Garcia-Elias M, An K‑N, Cooney WP, Linscheid RL, Chao EY (1989) Stability of the transverse carpal arch: An experimental study. J Hand Surg Am 14(A):277–282. doi:10.1016/0363-5023(89)90021-x
Garcia-Elias M, Sanchez-Freijo JM, Salo JM, Lluch AL (1992) Dynamic changes of the transverse carpal arch during flexion-extension of the wrist. J Hand Surg Am 17(A):1017–1019. doi:10.1016/s0363-5023(09)91049-8
Gartsman GM, Kovach JC, Crouch CC, Noble PC, Bennett JB (1986) Carpal arch alteration after carpal tunnel release. J Hand Surg Am 11(A):372–374. doi:10.1016/s0363-5023(86)80144-7
Gelberman RH, Menon J (1980) The vascularity of the scaphoid bone. J Hand Surg Am 5(A):508–513. doi:10.1016/s0363-5023(80)80087-6
von Gersdorff H (1529) Feldbuch der Wundarzney, 2. Auflage.
Greenspan A, Gerscovich EO (1993) Bilateral os centrale carpi: A rare congenital variant. J Hand Surg Am 18(A):586–587. doi:10.1016/0363-5023(93)90294-d
Grettve S (1955) Arterial anatomy of the carpal bones. Acta Anat 25:331–345
Gruber W (1877) Os naviculare carpi bipartitum. Arch Pathol Anat 69:391–396
Haerle M, Schaller HE, Mathoulin C (2003) Vascular anatomy of the palmar surfaces of the distal radius and ulna: Its relevance to pedicled bone grafts at the distal palmar forearm. J Hand Surg Eur Vol 28(B):131–136. doi:10.1016/s0266-7681(02)00279-6
Heinzelmann AD, Archer G, Bindra RR (2007) Anthropometry of the human scaphoid. J Hand Surg Am 32(A):1005–1008. doi:10.1016/j.jhsa.2007.05.030
Ingram C, Hall RF, Gonzalez M (1997) Congenital fusion of the scaphoid, trapezium, trapezoid and capitate. J Hand Surg Eur Vol 22(B):167–168. doi:10.1016/s0266-7681(97)80053-8
Ishiko T, Puttlitz CM, Lotz JC, Diao E (2003) Scaphoid kinematic behavior after division of the transverse carpal ligament. J Hand Surg Am 28(A):267–271. doi:10.1053/jhsu.2003.50055
Kauer JM (1974) The interdependence of carpal articulation chains. Acta Anat (Basel) 88:481–501
Kauer JM, de Lange A (1987) The carpal joint. Hand Clin 3:23–29
Kijima Y, Viegas SF (2009) Wrist anatomy and biomechanics. J Hand Surg Am 34(A):1555–1563. doi:10.1016/j.jhsa.2009.07.019
Knezevich S, Gottesman M (1990) Symptomatic scapholunatotriquetral carpal coalition with fusion of the capitatometacarpal joint. Clin Orthop Relat Res 251:153–156
Kong W, Xu Y, Wang Y, Chen S, Liu Z, Li X (2009) Anatomic measurement of wrist scaphoid and ist clinical significance. Chin J Traumatol 12:41–44
Krause W (1909) Skelet der oberen und unteren Extremität. In: v. Bardeleben K (Hrsg) Handbuch der Anatomie des Menschen, Bd. 1, 3. Abt. Gustav Fischer, Jena, S 1–266
Kuhlmann JN, Guerin-Surville H (1981) Vascularisation extrinsèque et intrinsèque du scaphoid et de l’os lunaire. Bull Assoc Anat 65:433–446
Lane LB, Gould ES, Stein PD, Coffey E (1990) Unilateral osteonecrosis in a patient with bilateral os centrale carpi. J Hand Surg Am 15(A):751–754. doi:10.1016/0363-5023(90)90150-p
Langer MF, Wieskötter B, Herrmann K, Oeckenpöhler S (2015) Bandplastik bei Instabilität des Sattelgelenks. Operat Orthop Traumatol 27:414–426
Langer MF, Wieskötter B, Vordemvenne T, Surke C (2010) Der osteochondrale Ersatz der Fossa lunata bei der Entfernung der proximalen Handwurzelreihe im frühen Stadium IV der Lunatumnekrose. Handchir Mikrochir Plast Chir 42:212–215
Le Minor JM, Rapp E (2001) Relative weights of the human carpal bones: biological and functional interests. Ann Anat 183:537–543
Louis DS, Calhoun TP, Garn SM, Carroll RE, Burdi AR (1976) Congenital bipartite scaphoid – fact or fiction? J Bone Joint Surg Am 58(A):1108–1112
Moritomo H, Viegas SF, Nakamura K, Dasilva MF, Patterson RM (2000) The scaphotrapezio-trapezoidal joint. Part 1: An anatomic and radiographic study. J Hand Surg Am 25(A):899–910. doi:10.1053/jhsu.2000.4582
Nakamura R, Hori M, Imamura T et al (1989) Method for measurement and evalution of carpal bone angles. J Hand Surg AM 14(A):412–416. doi:10.1016/0363-5023(89)90127-5
Nauck E (1938) Extremitätenskelett der Tetrapoden. In: Bolk L, Göppert E, Kallius E, Lubosch W (Hrsg) Handbuch der vergleichenden Anatomie der Wirbeltiere, Bd. 5. Urban & Schwarzenberg, Berlin, Wien, S 71–248
Neshkova IS, Jakubietz RG, Kuk D, Jakubietz MG, Meffert RH, Schmidt K (2015) Perkutane kanülierte Verschraubung nicht oder minimal dislozierter Skaphoidfrakturen. Operat Orthop Traumatol 27:448–454
Novak MD (1991) Material properties of ligaments. In: An K‑N, Berger RA, Cooney WP (Hrsg) Biomechanics of the wrist joint. Springer, New York, S 139–156
Oehmke MJ, Podranski T, Klaus R, Knolle E et al (2009) The blood supply of the scaphoid bone. J Hand Surg Eur Vol 34(E):351–357. doi:10.1177/1753193408100117
Patterson RM, Moritomo H, Yamaguchi S, Mitsuyasu H, Shah M, Buford WL, Viegas SF (2003) Scaphoid anatomy and mechanics. Update and review. Oper Techn Orthop 13:2–10
Pfitzner W (1900) Beiträge zur Kenntnis des menschlichen Extremitätenskelettes. VIII. Die morphologischen Elemente des menschlichen Handskelettes. Z Morphol Anthropol 2:77–157 (365–678)
Poirier P, Charpy A (1899) Traité d’anatomie humaine. Masson et Cie, Paris
Rajan PV, Day CS (2015) Scapholunate interosseous ligament anatomy and biomechanics. J Hand Surg Am 40(8):1692–1702. doi:10.1016/j.jhsa.2015.03.032
Salva-Coll G, Garcia-Elias M, Llusa-Perez M, Rodriguez-Baeza A (2011) Experimental study of the consequences of resection of the flexor retinaculum on the stability of the scaphoids. Rev Esp Cir Ortop Traumatol 55:224–230
Savelberg HH, Kooloos JG, Huiskes R, Kauer JM (1992) Stiffness of the ligaments of the human wrist joint. J Biomech 25:369–376
Schmidle G, Rieger M, Klauser AS, Thauerer M, Hoermann R, Gabl M (2014) Intraosseous rotation of the scaphoid: Assessment by using a 3D CT model – an anatomic study. Eur Radiol 24:1357–1365
Starck D (1978) Vergleichende Anatomie der Wirbeltiere auf evolutionsbiologischer Grundlage Bd. 1‑3. Springer, Berlin
Taleisnik J (1985) The bones of the wrist. In: Taleisnik J (Hrsg) The wrist. Churchill Livingstone, New York, S 1–12
Taleisnik J, Kelly PJ (1966) The extraosseous and intraosseous blood supply of the scaphoid bone. J Bone Joint Surg Am 48(6):1125–1137
Van de Giessen M, Foumani M, Streekstra GJ, Strackee SD, Maas M, van Vliet LJ, Grimbergen KA, Vos FM (2010) Statistical descriptions of scaphoid and lunate bone shapes. J Biomech 43:1463–1469
Vesalius A. (1543) De humani corporis fabrica. Basel
Viegas SF, Yamaguchi S, Boyd NL et al (1999) The dorsal ligaments of the wrist: Anatomy, mechanical properties, and function. J Hand Surg Am 24(3):456–468. doi:10.1053/jhsu.1999.0456
Viegas SF, Tencer AF, Cantrell J et al (1987) Load transfer characteristics of the wrist. Part 1: The normal joint. J Hand Surg Am 12(6):971–978. doi:10.1016/s0363-5023(87)80093-x
Viegas SF, Patterson RM, Todd P et al (1993) Load mechanics of the midcarpal joint. J Hand Surg Am 18(1):14–18. doi:10.1016/0363-5023(93)90238-x
Watts AC, McLean JM, Fogg Q, Bain GI (2011) Scaphoid anatomy. In: Slutsky D III, Slade J (Hrsg) The scaphoid. Thieme, New York
Wozasek GE, Laske H (1991) The ligaments of the scaphoid bone. Handchir Mikrochir Plast Chir 23:18–22
Zielinski CJ, Gunther SF (1981) Congenital fusion of the scaphoid and trapezium. Case report. J Hand Surg Am 6(3):220–222. doi:10.1016/s0363-5023(81)80073-1
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Interessenkonflikt
M. F. Langer, S. Oeckenpöhler, S. Breiter, D. Wähnert und B. Wieskötter geben an, dass kein Interessenkonflikt besteht.
Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.
Rights and permissions
About this article
Cite this article
Langer, M.F., Oeckenpöhler, S., Breiter, S. et al. Anatomie und Biomechanik des Kahnbeins. Orthopäde 45, 926–937 (2016). https://doi.org/10.1007/s00132-016-3339-5
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00132-016-3339-5