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Funktionelle Anatomie und Biomechanik des Karpus

Functional anatomy and biomechanics of the carpus

  • Handwurzel und Finger
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Zusammenfassung

Die Handwurzel ist ein komplexes Mosaik von Skelettelementen mit einer Vielzahl von Gelenken und einem differenzierten Ligamentsystem. Die gegensätzlichen Anforderungen aus hoher Belastungsstabilität und hoher Bewegungsfreiheit werden durch folgende Funktionsprinzipien realisiert:

  • Die proximale Handwurzelreihe ist ein mobiles Glied, das zwischen die fixen Elemente des Unterarms und der distalen Reihe interponiert ist. Mit „variabler Geometrie“ passt die proximale Reihe ihre Form entsprechend den aktuellen Raum- und Krafterfordernissen an.

  • Am Handgelenk kommt es zu kombinierten Bewegungen in 2 Raumebenen, wobei die Radialduktion mit einer Flexion und die Ulnarduktion mit einer Extension kombiniert sind.

  • In der Kombination mit den Umwendbewegungen im distalen Radioulnargelenk sowie den karpalen Abduktions- und Flexions-/Extensionsbewegungen kann die Hand multiplanar auf einer kugelförmigen Oberfläche bewegt werden.

  • Die karpale Funktion lässt sich funktionell am besten mit dem „Modell eines unter Spannung stehenden Ringsystems“ erklären.

Die Übersichtsarbeit skizziert die Anatomie und Biomechanik der Handwurzel und stellt die systematische Bildanalyse unter Verwendung von Hilfslinien, karpalen Winkeln und Längenindizes vor.

Abstract

The wrist is an exceedingly complex structure composed of several joints and a dedicated ligamentous system. Its functional principles allow a wide range of carpal motion and make the wrist remarkably resistant to external stress forces:

  • The proximal carpal row serves as an intercalated link interposed between the static elements of both the forearm and the distal carpal row. Like a flexible placeholder, the proximal row synchronously adapts to the spatial and temporal requirements of the wrist.

  • There are synergistic movement patterns including simultaneous flexion of the proximal row as the wrist is deviated radially and simultaneous extension during ulnar deviation.

  • Together with pronosupination of the radioulnar joints, the combined radial/ulnar inclination and flexion/extension enable spherical, out-of-plane movements of the hand.

  • Carpal function is best explained by the “model of a ring under tension.”

This review addresses the anatomy and the biomechanics of the wrist and illustrates systematic image analysis by using carpal lines and angles as well as indices of carpal height.

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  1. Institut für Diagnostische und Interventionelle Radiologie, Herz- und Gefäßklinik GmbH, Salzburger Leite 1, 97616 , Bad Neustadt an der Saale

    R. Schmitt

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Schmitt, R. Funktionelle Anatomie und Biomechanik des Karpus. Radiologe 46, 638–648 (2006). https://doi.org/10.1007/s00117-006-1397-0

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