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Die Anatomie des ulnokarpalen Komplexes

Anatomy of the ulnocarpal complex

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Zusammenfassung

Der ulnokarpale Komplex stellt ein verwickeltes System von Strukturen dar, das die Bewegungsführung, Stabilität und Druckübertragung im ulnokarpalen Kompartiment des proximalen Handgelenks sicherstellt. Anatomisch besteht dieses System aus dem Discus ulnocarpalis (Discus articularis, „triangular fibrocartilage“), den Ligg. radioulnare palmare und dorsale, den Ligg. ulnolunatum, ulnotriquetrum und ulnocapitatum, dem Meniscus ulnocarpalis („ulnocarpal meniscus homologue“), dem Recessus ulnaris („prestyloid recess“), dem Lig. collaterale carpi ulnare und der Sehnenscheide des M. extensor carpi ulnaris. Eng verbunden damit und funktionell nicht zu trennen, muss man das distale Radioulnargelenk und distale Anteile der Membrana interossea antebrachii hinzurechnen. Sie erlauben, zusammen mit dem proximalen Radioulnargelenk, Drehbewegungen der Hand im Sinne der Pro- und Supination und somit Einstellungen und Betätigungen der Hand im Raum mit einem Gewinn universeller Fertigkeiten.

In diesem Übersichtsartikel werden sämtliche Bestandteile des ulnokarpalen Komplexes systematisch erläutert, Größenmerkmale und Variationen aufgeführt und die funktionelle Bedeutung analysiert. Die Erkenntnisse sollen als anatomische Grundlage für mögliche Eingriffe sowohl am ulnokarpalen Komplex als auch am distalen Radioulnargelenk dienen.

Abstract

The ulnocarpal complex (triangular fibrocartilage complex; TFCC) represents an intricate system of structures which secures motion guidance, stability and pressure transmission in the ulnocarpal compartment of the wrist joint. Anatomically, this complex consists of the ulnocarpal disc (triangular disc), palmar and dorsal radioulnar ligaments, ulnolunate, ulnotriquetral and ulnocapitate ligaments, ulnocarpal meniscus homologue, ulnar recess (prestyloid recess), ulnocarpal collateral ligament and tendon sheath of the extensor carpi ulnaris. The distal radioulnar joint and the interosseous membrane of the forearm, which lie close together, also belong functionally to the ulnocarpal complex. Together with the proximal radioulnar joint, they permit rotational movements of the hand (pronation and supination).

This review highlights all components of the ulnocarpal complex systematically. Distinctive characteristics involving size, as well as variations, are listed, and their functional meaning analyzed. The accumulated knowledge serves as a basis for possible interventions both at the ulnocarpal complex and the distal radioulnar joint.

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Danksagung.

Alle Abbildungen wurden mit freundlicher Genehmigung aus Schmidt u. Lanz [48] entnommen.

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  1. Anatomisches Institut, Rheinische Friedrich-Wilhelms-Universität, Bonn

    H.-M. Schmidt

  2. Anatomisches Institut, Rheinische Friedrich-Wilhelms-Universität, Nußallee 10, 53115, Bonn

    H.-M. Schmidt

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Schmidt, HM. Die Anatomie des ulnokarpalen Komplexes. Orthopäde 33, 628–637 (2004). https://doi.org/10.1007/s00132-004-0665-9

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