{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T10:13:41Z","timestamp":1773483221852,"version":"3.50.1"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>In ca. 15% aller F\u00e4lle kommt es bei Skaphoidfrakturen zur Ausbildung einer\n                        Pseudarthrose. Um einen karpalen Kollaps zu verhindern, ist eine\n                        zielf\u00fchrende Diagnostik und fr\u00fchzeitige Therapieeinleitung von immenser\n                        Bedeutung.<\/jats:p>\n                  <jats:p>In dieser Arbeit beschreiben wir den an der Klinik f\u00fcr Plastische und\n                        Handchirurgie des Universit\u00e4tsklinikums Freiburg etablierten Algorithmus zur\n                        Behandlung der Skaphoidpseudarthrose. Wir f\u00fchrten eine monozentrische,\n                        retrospektive Untersuchung der an unserer Klinik versorgten\n                        Skaphoidrekonstruktionen im Zeitraum vom Januar 2012 bis Dezember 2022\n                        durch. Hinsichtlich der Therapie erfolgte eine Einteilung in vier Gruppen\n                        anhand der Kriterien Durchblutung des proximalen Pols sowie dem\n                        Substanzdefekt und\/ oder dem Vorliegen einer Humpback-Deformit\u00e4t. Bei\n                        vitalem proximalen Skaphoidpol erfolgte die Rekonstruktion mit avaskul\u00e4ren\n                        autologen Knochentransplantaten, entweder mit Radiusspongiosa wenn kein\n                        Substanzdefekt vorlag oder mit Beckenkammspan bei relevantem Substanzdefekt\n                        oder einer Humpback-Deformit\u00e4t. Bei avitalem proximalen Pol ohne relevantem\n                        Substanzdefekt und Humpback-Deformit\u00e4t erfolgte die Rekonstruktion mittels\n                        vaskularisiertem Radiusspan, bei Vorliegen eines Substanzdefekts bzw.\n                        Humpback-Deformit\u00e4t mit freier medialer Femurkondyle. Der Erfolg der\n                        Therapie wurde retrospektiv anhand der kn\u00f6chernen Durchbauung bemessen;\n                        dar\u00fcber hinaus analysierten wir die epidemiologischen Daten des\n                        Kollektivs.<\/jats:p>\n                  <jats:p>Es wurden 123 Skaphoidrekonstruktionen eingeschlossen. Das Follow Up betrug\n                        im Median 422 Tage. Im genannten Zeitraum erfolgten entsprechend des\n                        etablierten Algorithmus dreizehn Rekonstruktionen mit Radiusspongiosa, 82\n                        mit Beckenkammspan, dreizehn mit vaskularisiertem Radiusspan und f\u00fcnfzehn\n                        mit freier medialer Femurkondyle. Bei der Versorgung mit Radiusspongiosa\n                        wurde eine Durchbauung von 84,6%, mit Beckenkammspan von 79,3%, mit\n                        vaskularisiertem Radiusspan von 69,2% und bei freier medialer Femurkondyle\n                        von 86,7% festgestellt. Anhand der von uns analysierten Kohorte konnten wir\n                        Nikotinabusus in der Subgruppe der Skaphoidrekonstruktionen mit\n                        Beckenkammspan als unabh\u00e4ngigen Risikofaktor f\u00fcr eine ausbleibende\n                        Durchbauung identifizieren.<\/jats:p>\n                  <jats:p>Einhergehend mit der aktuellen Literatur konnten wir die enorme Bedeutung der\n                        Nikotinkarenz bei Skaphoidrekonstruktionen in unserer Analyse best\u00e4tigen. Da\n                        der Behandlungsalgorithmus in unserer Studie aufgrund des retrospektiven\n                        Designs vorgegeben war, kann keine Aussage zur \u00dcberlegenheit einer Methode\n                        getroffen werden. Um die \u00dcberlegenheit einer Behandlungsmethode zu zeigen\n                        sind prospektive, randomisierte Studien notwendig.<\/jats:p>","DOI":"10.1055\/a-2685-3879","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T22:30:30Z","timestamp":1761172230000},"page":"335-343","source":"Crossref","is-referenced-by-count":1,"title":["Therapie der Skaphoidpseudarthrose \u2013 Behandlungsalgorithmus und\n                    Analyse der Durchbauungsrate bei autologer Rekonstruktion"],"prefix":"10.1055","volume":"57","author":[{"given":"Ayla Antonia","family":"Hohenstein","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische und Handchirurgie, Universit\u00e4tsklinikum Freiburg,\n                    Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cam Tu","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische und Handchirurgie, Universit\u00e4tsklinikum Freiburg,\n                    Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Zeller","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische und Handchirurgie, Universit\u00e4tsklinikum Freiburg,\n                    Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Fricke","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische und Handchirurgie, Universit\u00e4tsklinikum Freiburg,\n                    Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Horst","family":"Zajonc","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische und Handchirurgie, Universit\u00e4tsklinikum Freiburg,\n                    Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen Ulrich","family":"Eisenhardt","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische und Handchirurgie, Universit\u00e4tsklinikum Freiburg,\n                    Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nico","family":"Leibig","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Plastische und Handchirurgie, Universit\u00e4tsklinikum Freiburg,\n                    Freiburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"594","DOI":"10.3238\/arztebl.m2024.0102","article-title":"The conservative and operative treatment of carpal fractures","volume":"121","author":"A C Ku\u00dfmaul","year":"2024","journal-title":"Dtsch Arztebl Int"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1797","DOI":"10.1016\/j.jhsa.2015.05.003","article-title":"Treatment of Scaphoid Nonunion: A Systematic Review of the Existing\n                    Evidence","volume":"40","author":"R M Pinder","year":"2015","journal-title":"J Hand Surg Am"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1007\/s001130050626","article-title":"Kahnbeinfrakturen \u2013 Diagnostik, Klassifikation und Therapie","volume":"103","author":"H Krimmer","year":"2000","journal-title":"Der Unfallchirurg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1055\/s-1999-13516","article-title":"Proximal scaphoid nonunion-osteosynthesis","volume":"31","author":"T J Herbert","year":"1999","journal-title":"Handchir Mikrochir Plast Chir"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1007\/s10039-016-0147-4","article-title":"Skaphoidfraktur und Skaphoidpseudarthrose","volume":"18","author":"A Arsalan-Werner","year":"2016","journal-title":"Trauma Berufskrankh"},{"key":"ref6","volume-title":"Hrsg. 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