{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,6,29]],"date-time":"2024-06-29T12:40:20Z","timestamp":1719664820495},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Ziel Untersuchung und Klassifikation der Auswirkungen der Ausheilung\n                    distaler extraartikul\u00e4rer Radiusfrakturen in Fehlstellung auf das\n                    karpale Gef\u00fcge.<\/jats:p><jats:p>\n          Material und Methoden Auf den pr\u00e4operativen, streng seitlichen\n                    R\u00f6ntgenaufnahmen des Handgelenkes von 72 Patienten mit einer\n                    symptomatischen fehlverheilten extraartikul\u00e4ren distalen Radiusfraktur,\n                    43 mit Dorsal- und 29 mit vermehrter Palmarkippung der\n                    Speichengelenkfl\u00e4che, wurden die Neigung der\n                    Speichengelenkfl\u00e4che sowie der radiolun\u00e4re (RL-) und der\n                    kapitolun\u00e4re Winkel bestimmt. Das Ausma\u00df der Fehlstellung der\n                    Speichengelenkfl\u00e4che wurde definiert als der Winkel zwischen der\n                    Senkrechten zur L\u00e4ngsachse des Radius und der Tangente an die dorsale\n                    und palmare Radiuslippe plus 11\u00b0 bei Dorsalkippung und minus 11\u00b0\n                    bei vermehrter Palmarkippung der Radiusgelenkfl\u00e4che. Dabei wurden der\n                    errechnete Wert bei Palmarkippung der Gelenkfl\u00e4che mit einem\n                    vorangestellten Minuszeichen versehen. Im Rahmen der Radiuskorrekturosteotomie\n                    erfolgte bei 9 Patienten mit Ausheilung des distalen Radius mit Dorsalkippung\n                    der Gelenkfl\u00e4che aus verschiedenen Gr\u00fcnden eine\n                    Abkl\u00e4rung des skapholun\u00e4ren Bandes. Vier dieser Patienten wiesen\n                    eine Komplettruptur des skapholun\u00e4ren Bandes auf.<\/jats:p><jats:p>\n          Ergebnisse Anhand des RL-Winkels wurden 4 verschiedene Konstellationen des\n                    karpalen Gef\u00fcges im Rahmen fehlverheilter distaler\n                    extraartikul\u00e4rer Radiusfrakturen identifiziert: Typ P mit Palmarkippung\n                    des Lunatums und einem RL-Winkel kleiner \u2212\u200912\u00b0; Typ K\n                    mit einer kollinearen Verschiebung der L\u00e4ngsachse des Karpus\n                    gegen\u00fcber der L\u00e4ngsachse der Speiche mit einem RL-Winkel\n                    zwischen \u2212\u200912 und 10\u00b0; Typ A mit Dorsalkippung des\n                    Lunatums \u00fcber 10\u00b0, jedoch kleiner als das Ausma\u00df der\n                    Verkippung der Speichengelenkfl\u00e4che und Typ D mit einem RL-Winkel\n                    gr\u00f6\u00dfer als das Ausma\u00df der Verkippung der\n                    Speichengelenkfl\u00e4che. Sowohl bei mit Dorsalkippung als auch mit\n                    vermehrter Palmarneigung fehlgeheilten Radiusfrakturen fanden sich alle 4\n                    Karpuskonstellationen. Dabei war der Typ A, der dem adaptiven Karpus entspricht,\n                    mit 25 von 43 F\u00e4llen bei mit Dorsalkippung der\n                    Speichengelenkfl\u00e4che fehlverheilten Frakturen f\u00fchrend und die\n                    kollineare Subluxation des Karpus (Typ K) mit 12 von 29 F\u00e4llen bei mit\n                    vermehrter Palmarneigung der Gelenkfl\u00e4che verheilten Frakturen. Um die\n                    Kippung des Lunatums auszugleichen und die L\u00e4ngsachse der Hand parallel\n                    zur L\u00e4ngsachse des Radius auszurichten, erfolgte bei mit Dorsalkippung\n                    der Gelenkfl\u00e4che verheilten Radiusfrakturen eine zum Lunatum\n                    gegenl\u00e4ufige Kippung des Kapitatums. Bei mit vermehrter Palmarneigung\n                    der Gelenkfl\u00e4che verheilten Frakturen f\u00fchrte eine Extension des\n                    Kapitatums zur Neutralstellung der Hand. Vier der 5 Patienten mit einer\n                    Konstellation des Karpus vom Typ D mit Abkl\u00e4rung des\n                    skapholun\u00e4ren Bandes wiesen eine Komplettruptur des Bandes auf.<\/jats:p><jats:p>\n          Schlussfolgerung In dieser Studie konnten vier verschiedene\n                    Konstellationen des karpalen Gef\u00fcges bei fehlverheilten\n                    extraartikul\u00e4ren distalen Radiusfrakturen gefunden werden. Der Typ D\n                    sollte bei mit Dorsalkippung der Radiusgelenkfl\u00e4che verheilten Frakturen\n                    an eine skapholun\u00e4re Bandruptur denken lassen, weshalb in diesen\n                    F\u00e4llen eine entsprechende Abkl\u00e4rung sinnvoll erscheint.<\/jats:p>","DOI":"10.1055\/a-2074-3095","type":"journal-article","created":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T23:46:11Z","timestamp":1683589571000},"page":"211-215","source":"Crossref","is-referenced-by-count":1,"title":["Konstellationen des karpalen Gef\u00fcges bei fehlverheilten\n                    extraartikul\u00e4ren distalen Radiusfrakturen"],"prefix":"10.1055","volume":"55","author":[{"given":"Karl-Josef","family":"Prommersberger","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Elektive Handchirurgie, St. Josef Krankenhaus\n                    Schweinfurt, Schweinfurt, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Ring","sequence":"additional","affiliation":[{"name":"Hand Clinic, Massachusetts General Hospital, Boston, United\n                    States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse B","family":"Jupiter","sequence":"additional","affiliation":[{"name":"Hand Clinic, Massachusetts General Hospital, Boston, United\n                    States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulrich","family":"Lanz","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Handchirurgie, Rh\u00f6n Klinikum AG, Bad\n                    Neustadt an der Saale, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,5,8]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.2106\/00004623-197254080-00003","article-title":"Traumatic instability of the wrist. 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