Berger R A
Department of Hand and Orthopedic Surgery, Mayo Clinic and Mayo Foundation, Department of Orthopedic Surgery and Anatomy, Mayo Graduate School of Medicine, Rochester, Minnestota, USA.
Hand Clin. 2001 Nov;17(4):525-32.
The scaphoid is a critical link in the mechanism of the carpus. Its complex shape allows it to participate in the kinematics of both the proximal and distal row. Because of its offset proximal and distal articular surfaces, it has a natural tendency to palmar-flex with longitudinal loading. Because of this, extension of the scaphoid places progressively increasing tension on the palmar cortex of the curved waist of the scaphoid. Excessive extension or ulnar deviation of the wrist, coupled with excessive loading, mechanically predisposes the scaphoid to fracture. This is especially true if the strong ligaments attaching to the scaphoid retain their integrity. When a fracture occurs proximal to the waist of the scaphoid, it is predisposed to displacement because of the opposing forces on the proximal [table: see text] and distal fragments as well as the distribution of ligament attachments. This, in turn, predisposes the proximal fragment to ischemic conditions because of the distal location of nutrient vessels and a retrograde intraosseous blood supply.
舟骨是腕关节机制中的关键连接部分。其复杂的形状使其能够参与近排和远排腕骨的运动学。由于其近端和远端关节面的偏移，在纵向负荷作用下它有自然的掌屈倾向。因此，舟骨的伸展使舟骨弯曲腰部的掌侧皮质承受的张力逐渐增加。手腕过度伸展或尺侧偏斜，再加上过度负荷，在机械作用上使舟骨易于骨折。如果附着于舟骨的强韧韧带保持完整，情况尤其如此。当骨折发生在舟骨腰部近端时，由于近端和远端骨折块上的相反作用力以及韧带附着的分布，骨折块易于移位。反过来，由于营养血管位置靠远侧以及逆行性骨内血供，近端骨折块易于出现缺血情况。
