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Anatomie und Pathobiomechanik des Skaphoids

Anatomy and pathobiomechanics of the scaphoid

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Zusammenfassung

Unter den Handwurzelknochen hat das Kahnbein (Os scaphoideum) die größte Bedeutung. Die häufigste Fraktur des Carpus ist der Kahnbeinbruch. Die ebenfalls häufige, ausbleibende Heilung dieses Bruchs führt wie die nichtgeheilte Ruptur des Bandkomplexes zwischen Kahnbein und Mondbein (Os lunatum) zu den folgenschwersten biomechanischen und damit gravierendsten klinischen Veränderungen des Handgelenks. Detaillierte Anatomie des Kahnbeins, Durchblutung, Bandverbindungen, Verletzungsmechanismen sowie Pathobiomechanik werden beschrieben und illustriert.

Abstract

Among the carpal bones the scaphoid (Os scaphoideum) is the most important. The most frequent fracture of the carpus is a fracture of the scaphoid bone. The frequently occurring absence of healing of these fractures as well as unhealed ruptures of the ligament complex between the scaphoid and lunate, lead to the most severe biomechanical and thus the most severe clinical changes of the wrist. The detailed anatomy of the scaphoid, blood flow, ligament attachments, injury mechanisms and pathobiomechanics are described and illustrated.

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Literatur

  1. Belsole RJ, Hilbelink DR, Llewellyn JA et al (1991) Carpal orientation from computed reference axes. J Hand Surg 16A:82–90

    Article  Google Scholar 

  2. Berger RA, Imeada T, Berglund L, An K‑N (1999) Constraint and material properties oft he subregions oft he scapholunate interosseous ligament. J Hand Surg 24A:953–962

    Article  Google Scholar 

  3. Berger RA (2001) The anatomy of the scaphoid. Hand Clin 17:525–532

    CAS  PubMed  Google Scholar 

  4. 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 24A:786–798

    Article  Google Scholar 

  5. Blevens AD, Light TR, Jablonsky WS et al (1989) Radiocarpal articular contact characteristics with scaphoid instability. J Hand Surg 14:781–790

    Article  CAS  Google Scholar 

  6. Botte MJ, Mortensen WW, Gelberman RH, Rhoades CE, Gellman H (1988) Internal vascularity of the scaphoid in cadavers after insertion oft he Herbert screw. J Hand Surg 13A:216–220

    Article  Google Scholar 

  7. 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 36A:1926–1935

    Article  Google Scholar 

  8. 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 36A:1936–1943

    Article  Google Scholar 

  9. Ceri N, Korman E, Gunal I, Tetik S (2004) The morphological and morphometric features of the scaphoid. J Hand Surg 29B:393–398

    Article  Google Scholar 

  10. 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 87A:2729–2740

    Article  Google Scholar 

  11. De Sambuy MTC, Burgess TM, Camcon-Binder A, Mathoulin C (2017) The anatomy oft he dorsal capsulo-scapholunate septum: a cadaveric study. J Wrist Surg 6:244–247

    Article  Google Scholar 

  12. Dubey PP, Chahan NK, Siddiqui MS (2011) Vascular foramina of the scaphoid and its clinical implications. Biomed Res 22:4–6

    Google Scholar 

  13. Garcia-Elias M, Cooney WP, An KN et al (1989) Wrist kinematics after limited intercarpal arthrodesis. J Hand Surg 14A:791–799

    Article  Google Scholar 

  14. Garcia-Elias M, An K‑N, Cooney WP, Linscheid RL, Chao EY (1989) Stability oft he transverse carpal arch: an experimental study. J Hand Surg 14A:277–282

    Article  Google Scholar 

  15. Garcia-Elias M, Sanchez-Freijo JM, Salo JM, Lluch AL (1992) Dynamic changes oft he transverse carpal arch during flexion-extension oft he wrist. J Hand Surg 17A:1017–1019

    Article  Google Scholar 

  16. Gartsman GM, Kovach JC, Crouch CC, Noble PC, Bennett JB (1986) Carpal arch alteration after carpal tunnel release. J Hand Surg 11A:372–374

    Article  Google Scholar 

  17. Gelberman RH, Menon J (1980) The vascularity of the scaphoid bone. J Hand Surg 5A:508–513

    Article  Google Scholar 

  18. Grettve S (1955) Arterial anatomy of the carpal bones. Acta Anat 25:331–345

    Article  CAS  Google Scholar 

  19. Haerle M, Schaller HE, Mathoulin C (2003) Vascular anatomy oft he palmar surfaces of the distal radius and ulna. J Hand Surg 28B:131–136

    Article  Google Scholar 

  20. Heinzelmann AD, Archer G, Bindra RR (2007) Anthropometry of the human scaphoid. J Hand Surg 32A:1005–1008

    Article  Google Scholar 

  21. Ingram C, Hall RF, Gonzalez M (1997) Congenital fusion of the scaphoid, trapezium, trapezoid and capitate. J Hand Surg 22B:167–168

    Article  Google Scholar 

  22. Ishiko T, Puttlitz CM, Lotz JC, Diao E (2003) Scaphoid kinematic behavior after division of the transverse carpal ligament. J Hand Surg 28A:267–271

    Article  Google Scholar 

  23. Kauer JM (1974) The interdependence of carpal articulation chains. Acta Anat (basel) 88:481–501

    Article  CAS  Google Scholar 

  24. Kauer JM, de Lange A (1987) The carpal joint. Hand Clin 3:23–29

    CAS  PubMed  Google Scholar 

  25. Kijima Y, Viegas SF (2009) Wrist anatomy and biomechanics. J Hand Surg 34A:1555–1563

    Article  Google Scholar 

  26. 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

    PubMed  Google Scholar 

  27. Krause W (1909) Skelet der oberen und unteren Extremität. In: v. Bardeleben K (Hrsg) Handbuch der Anatomie des Menschen, Bd. 1. Gustav Fischer, Jena, S 1–266 (3. Abt)

    Google Scholar 

  28. Kuhlmann JN, Guerin-Surville H (1981) Vascularisation extrinsèque et intrinsèque du scaphoid et de l’os lunaire. Bull Assoc Anat (Nancy) 65:433–446

    CAS  Google Scholar 

  29. Lane LB, Gould ES, Stein PD, Coffey E (1990) Unilateral osteonecrosis in a patient with bilateral os centrale carpi. J Hand Surg 15A:751–754

    Article  Google Scholar 

  30. Langer MF, Wieskötter B, Herrmann K, Oeckenpöhler S (2015) Bandplastik bei Instabilität des Sattelgelenks. Operat Orthop Traumatol 27:414–426

    Article  CAS  Google Scholar 

  31. Langer MF, Wieskötter B, Vordemvenne T, Surke C (2010) Der osteochondrale Ersatz der Fovea lunata. Handchir Mikrochir Plast Chir 42:212–215

    Article  CAS  Google Scholar 

  32. Langer MF, Oeckenpöhler S, Breiter S, Wähnert D, Wieskötter B (2016) Anatomie und Biomechanik des Kahnbeins. Orthopade 45:926–937

    Article  CAS  Google Scholar 

  33. Le Minor JM, Rapp E (2001) Relative weights of the human carpal bones: biological and functional interests. Ann Anat 183:537–543

    Article  Google Scholar 

  34. Louis DS, Calhoun TP, Garn SM, Carroll RE, Burdi AR (1976) Congenital bipartite scaphoid—fact or fiction? J Bone Joint Surg 58A:1108–1112

    Article  Google Scholar 

  35. 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 25A:899–910

    Article  Google Scholar 

  36. Nakamura R, Hori M, Imamura T et al (1989) Method for measurement and evalution of carpal bone angles. J Hand Surg 14A:412–416

    Article  Google Scholar 

  37. Neshkova IS, Jakubietz RG, Kuk D, Jakubietz MG, Meffert RH, Schmidt K (2015) Perkutane kanülierte Verschraubung nicht oder minimal dislozierter Skaphoidfrakturen. Oper Orthop Traumatol 27:448–454

    Article  CAS  Google Scholar 

  38. Novak MD (1991) Material properties of ligaments. In: An K‑N, Berger RA, Cooney WP (Hrsg) Biomechanics oft he wrist joint. Springer, New York, S 139–156

    Google Scholar 

  39. Oehmke MJ, Podranski T, Klaus R, Knolle E et al (2009) The blood supply oft he scaphoid bone. J Hand Surg 34E:351–357

    Article  Google Scholar 

  40. Patterson RM, Moritomo H, Yamaguchi S, Mitsuyasu H, Shah M, Buford WL, Viegas SF (2003) Scaphoid anatomy and mechanics. Update and review. Oper Tech Orthop 13:2–10

    Article  Google Scholar 

  41. Pfitzner W (1900) Beiträge zur Kenntnis des menschlichen Extremitätenskelettes. VIII. Die morphologischen Elemente des menschlichen Handskelettes. Z Morphol Anthropol 2:77–157, 365–678

    Google Scholar 

  42. Poirier P, Charpy A (1899) Traité d’anatomie humaine. Masson et Cie, Paris

    Google Scholar 

  43. Rajan PV, Day CS (2015) Scapholunate interosseous ligament anatomy and biomechanics. J Hand Surg 40:1692–1702

    Article  Google Scholar 

  44. Salva-Coll G, Garcia-Elias M, Llusa-Perez M, Rodriguez-Baeza A (2011) Experimental study oft he consequences of resection of the flexor retinaculum on the stability oft he scaphoids. Rev Esp Cir Ortop Traumatol 55:224–230

    Google Scholar 

  45. Savelberg HH, Kooloos JG, Huiskes R, Kauer JM (1992) Stiffness of the ligaments of the human wrist joint. J Biomech 25:369–376

    Article  CAS  Google Scholar 

  46. 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

    Article  Google Scholar 

  47. Taleisnik J (1985) The bones of the wrist. In: Taleisnik J (Hrsg) The wrist. Churchill Livingstone, New York, S 1–12

    Google Scholar 

  48. Taleisnik J, Kelly PJ (1966) The extraosseous and intraosseous blood supply of the scaphoid bone. J Bone Joint Surg 48A:1125–1137

    Article  Google Scholar 

  49. 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

    Article  Google Scholar 

  50. Van Overstraeten L, Camus EJ, Wahegaonkar A, Messina J, Tandara AA, Binder AC, Mathoulin CL (2013) Anatomical description of the dorsal capsulo-scapholunate septum (DCSS). Arthroscopic staging of scapholunate instability after DCSS sectioning. J Wrist Surg 2:149–154

    Article  Google Scholar 

  51. Viegas SF, Yamaguchi S, Boyd NL et al (1999) The dorsal ligaments of the wrist: Anatomy, mechanical properties, and function. J Hand Surg 24A:456–468

    Article  Google Scholar 

  52. Viegas SF, Tencer AF, Cantrell J et al (1987) Load transfer characteristics of the wrist. Part 1: the normal joint. J Hand Surg 12A:971–978

    Article  Google Scholar 

  53. Viegas SF, Patterson RM, Todd P et al (1993) Load mechanics of the midcarpal joint. J Hand Surg 18A:14–18

    Article  Google Scholar 

  54. Watts AC, McLean JM, Fogg Q, Bain GI (2011) Scaphoid anatomy. In: Slutsky D III, Slade J (Hrsg) The scaphoid. Thieme, New York

    Google Scholar 

  55. Wozasek GE, Laske H (1991) The ligaments of the scaphoid bone. Handchir Mikrochir Plast Chir 23:18–22

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstr. 1, 48149, Münster, Deutschland

    M. F. Langer, S. Breiter, J. Ueberberg, B. Wieskötter & S. Oeckenpöhler

  2. Abteilung für Handchirurgie, Vulpius Klinik GmbH Bad Rappenau, Vulpiusstr. 29, 74906, Bad Rappenau, Deutschland

    F. Unglaub

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  1. M. F. Langer
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Correspondence to M. F. Langer.

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M.F. Langer, F. Unglaub, S. Breiter, J. Ueberberg, B. Wieskötter und S. Oeckenpöhler geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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M. Schädel-Höpfner, Neuss

Dieser Artikel basiert auf dem Beitrag: Langer MF, Oeckenpöhler S, Breiter S, Wähnert D, Wieskötter B (2016) Anatomie und Biomechanik des Kahnbeins. Orthopäde 45:926–937.

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Langer, M.F., Unglaub, F., Breiter, S. et al. Anatomie und Pathobiomechanik des Skaphoids. Unfallchirurg 122, 170–181 (2019). https://doi.org/10.1007/s00113-018-0597-1

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  • DOI: https://doi.org/10.1007/s00113-018-0597-1

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