Anatomie und Pathobiomechanik des Skaphoids

Langer, Martin; Unglaub, Frank; Breiter, Sarah; Ueberberg, Johanna; Wieskötter, Britta; Oeckenpöhler, Simon

doi:10.1007/s00113-018-0597-1

Cited by 16 publications

(11 citation statements)

References 48 publications

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“…Its longitudinal axis is oriented at approximately 45°to the longitudinal axis of the hand in both the sagittal and coronal planes. 5 This complex morphology hampers the interpretation of the radiographs, the pattern of the fractures, and the evaluation of the displacement.…”

Section: Anatomymentioning

confidence: 99%

“…The vascularization of the remaining 20% to 30% distal scaphoid is performed by small, direct palmar branches from the radial artery or superficial palmar arch that enter the scaphoid tubercle and the collateral circulation from the anterior interosseous artery. 2,5,8,9 Some authors believe that vessels from scaphoid proximal and distal areas communicate within the bone, 10 but others do not. 9 Similarly, some authors speak about a potential third source of blood supply, inconsistent and thin, through the scapholunate ligament, 11 while others vehemently question it.…”

Section: Anatomymentioning

confidence: 99%

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Diagnostic and Therapeutic Approach to Acute Scaphoid Fractures

Simón

Medrano

Delgado

2020

Revista Iberoamericana de Cirugía de la Mano

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The scaphoid is the carpal bone that most often fractures, accounting for up to 70% of carpal fractures and 11% of hand fractures. It is the second most common arm fracture, only surpassed by fractures of the distal radius. Despite being so common, these fractures can be difficult to diagnose and treat due to the anatomic and physiological particularities of the bone, including its precarious vascularization, its complex three-dimensional structure, and its ligament connections, which greatly contribute to the risk of complications such as malunion, pseudoarthrosis and avascular necrosis. Although there are many published studies on the treatment of these injuries, there is still controversy over what is the most suitable one for certain fracture types. The present article is a comprehensive and updated review of the literature. Combining strategies for clinical and radiological diagnosis, we propose a complete algorithm for the diagnosis of scaphoid fractures based on the varying availability of resources, and we also describe the most appropriate therapeutic approach for the different types of acute fractures of this bone.

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Section: Anatomymentioning

confidence: 99%

Section: Anatomymentioning

confidence: 99%

Diagnostic and Therapeutic Approach to Acute Scaphoid Fractures

Simón

Medrano

Delgado

2020

Revista Iberoamericana de Cirugía de la Mano

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“…Aus praktischen Gründen ist die Richtung der Verschraubung bei den häufigen Querfrakturen meist retrograd von palmar und bei kleinen proximalen Fragmenten anterograd von dorsal. Zweifellos braucht der Operateur für die Einbringung der Schraube viel Übung, denn das Kahnbein ist nicht gerade, sondern mehrfach in sich gedreht aufgebaut (Langer) [1]. Da die Skaphoidfragmente nicht selten gegeneinander verdreht sindu.…”

Section: Fehlgeschlagene Osteosynthesen Am Kahnbeinunclassified

Lösungsmöglichkeiten bei fehlgeschlagenen Osteosynthesen an der Hand

Langer¹,

Raschke²

2020

OP-JOURNAL

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ZusammenfassungFür Revisionsoperationen bei Osteosynthesen der Hand braucht der Chirurg viel Kreativität, Erfahrung und technisches Geschick. Die Osteosynthesen im karpalen Bereich benötigen Stabilität und Ruhe, während die Osteosynthesen an den Fingern Stabilität für eine frühzeitige Beübung benötigen. Die Stabilität an den Fingern muss so erreicht werden, dass die Weichteile nicht kompromittiert werden. Hier werden einige der Lösungsmöglichkeiten im karpalen, metakarpalen und phalangealen Bereich vorgestellt.

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“…Langer et al recently postulated that in a posttraumatic humpback deformity, only the palmar edges of the proximal and distal fragment touch each other. This insufficient contact of the fragments might be another cause of the increased rate of posttraumatic nonunion in the scaphoid [26].…”

Section: Introductionmentioning

confidence: 99%

Clinical and radiological results of the vascularized medial femoral condyle graft for scaphoid non-union

Keller

Kastenberger

Anoar

et al. 2020

Arch Orthop Trauma Surg

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Introduction This study evaluated the use of a free vascularized bone graft with and without cartilage from the medial femoral condyle (MFC) in patients with recalcitrant scaphoid non-union, with a special focus on union rates and the osteochondral graft for proximal pole destruction. Materials and methods Thirty-eight avascular scaphoid non-unions in 37 patients who were treated with a free osteoperiosteal or osteochondral MFC graft were retrospectively evaluated (mean follow-up 16 months). Bone union, the scapholunate and the radiolunate angles were evaluated on X-ray images. The range of motion, grip strength, VAS, DASH and PRWE scores were evaluated clinically. Results The overall union rate was 95%. Bone union was achieved in 27 out of 29 (93%) scaphoids treated with a free osteoperiosteal MFC grafts and in 9 out of 9 (100%) scaphoids treated with a free osteochondral MFC graft. The range of motion remained almost unchanged, while grip strength increased significantly (34 kg vs. 44 kg) and the VAS (22-5), DASH (59-19) and PRWE (62-30) score decreased significantly. The scapholunate (71°-65°) and radiolunate (28°-18°) angle decreased. No major donor site morbidity was observed. Postoperative complications were observed in eight cases (21%). Conclusions The vascularized medial femoral bone graft leads to a good functional outcome in the treatment of scaphoid non-unions. The graft provides adequate blood supply and structural stability to the scaphoid. A proximal pole destruction can be replaced using an osteochondral graft with promising short-term results preventing carpal osteoarthritis and collapse.

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Anatomie und Pathobiomechanik des Skaphoids

Cited by 16 publications

References 48 publications

Diagnostic and Therapeutic Approach to Acute Scaphoid Fractures

Diagnostic and Therapeutic Approach to Acute Scaphoid Fractures

Lösungsmöglichkeiten bei fehlgeschlagenen Osteosynthesen an der Hand

Clinical and radiological results of the vascularized medial femoral condyle graft for scaphoid non-union

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