舟骨的骨骼和韧带解剖结构：第一部分。一项突出争议点的系统文献综述
Osseous and ligamentous scaphoid anatomy: Part I. A systematic literature review highlighting controversies.
作者信息
Buijze Geert A, Lozano-Calderon Santiago A, Strackee Simon D, Blankevoort Leendert, Jupiter Jesse B
机构信息
Orthopaedic Research Center Amsterdam and Department of Plastic Reconstructive and Hand Surgery, Academic Medical Center, Amsterdam, The Netherlands.
出版信息
J Hand Surg Am. 2011 Dec;36(12):1926-35. doi: 10.1016/j.jhsa.2011.09.012. Epub 2011 Nov 3.
PURPOSE
The interpretation of scaphoid anatomy and kinematics is confusing and controversial. This results from a lack of consensus on the anatomy of the ligaments attaching to the scaphoid and an overwhelming variety of substantially different anatomic descriptions and classification systems of the wrist joint in the literature. The present study systemically reviews the consistencies or inconsistencies of the various scaphoid ligament descriptions and aims to clarify and unify different concepts and classification systems.
METHODS
We performed a systematic search of the medical literature from 1950 to 2010. We included all descriptive reports of the anatomy or morphology of the scaphoid, ligaments, or both. With the aim to describe the best available evidence, we considered all anatomical descriptions but emphasized a selection of the most frequently cited articles.
RESULTS
The literature search resulted in 555 potentially eligible descriptive reports, 58 of which met the inclusion criteria and were included in the review. Variations in the anatomic descriptions appear to be mostly due to the difficulty of identifying individual interdigitating ligaments or bundles by macroscopic dissections, as well as the interindividual variability in ligament anatomy. The most important areas of controversy in the scaphoid ligament attachments include the radial collateral ligament, dorsal radiocarpal ligament, dorsal intercarpal ligament, volar scaphotriquetral ligament, and scaphotrapezium-trapezoid ligament.
CONCLUSIONS
None of the scaphoid ligaments other than the scaphocapitate ligament have been described consistently. Future research is required to verify the ligament attachments that currently have the most controversial descriptions, while addressing the interindividual variability of ligament insertions and morphology.
CLINICAL RELEVANCE
Thorough knowledge of the anatomy will enhance our understanding of the kinematics of the scaphoid.
目的
舟骨的解剖结构和运动学解释令人困惑且存在争议。这是由于对于附着于舟骨的韧带解剖结构缺乏共识，以及文献中腕关节存在大量截然不同的解剖描述和分类系统。本研究系统回顾了各种舟骨韧带描述的一致性或不一致性，旨在阐明并统一不同的概念和分类系统。
方法
我们对1950年至2010年的医学文献进行了系统检索。纳入了所有关于舟骨、韧带或两者的解剖结构或形态的描述性报告。为了描述最佳现有证据，我们考虑了所有解剖描述，但重点选取了一些被频繁引用的文章。
结果
文献检索得到555篇可能符合条件的描述性报告，其中58篇符合纳入标准并被纳入综述。解剖描述的差异似乎主要是由于通过宏观解剖难以识别单个相互交错的韧带或束，以及韧带解剖结构的个体间差异。舟骨韧带附着处最主要的争议领域包括桡侧副韧带、桡腕背侧韧带、腕骨间背侧韧带、舟三角掌侧韧带以及舟大多角骨 - 小多角骨韧带。
结论
除了舟头韧带外，没有一种舟骨韧带的描述是一致的。未来需要进行研究以验证目前描述最具争议的韧带附着情况，同时解决韧带附着和形态的个体间差异问题。
临床意义
对解剖结构的全面了解将增进我们对舟骨运动学的理解。
Zotero 插件