Weisser C, Lanz U
Chirurgischen Universitätsklinik Würzburg.
Handchir Mikrochir Plast Chir. 1987 Nov;19(6):310-4.
In combination with its ligamentous connections, the scaphoid bone represents an essential stabilizing factor within the wrist. This stabilizing function disappears after trauma causing a displaced fracture of the scaphoid bone or extensive rupture of ligamentous structures fixing the scaphoid in its position. Hence carpal instability results, detectible radiographically by alteration of defined wrist angles. Since this is so, one might suppose that, together with other wellknown reasons, carpal instability would be of great importance in the development of a scaphoid nonunion. However, after evaluation of 76 cases, a scaphoid nonunion with carpal instability was found in only 27.6%. Moreover, surgical treatment of the scaphoid nonunion alone does not correct the abnormal wrist angles. Despite this observation, we do not consider simultaneous ligamentous repair to be necessary, because few problems remained after bony healing in such cases.
舟骨与它的韧带连接相结合，是腕关节内一个重要的稳定因素。在因舟骨移位骨折或固定舟骨位置的韧带结构广泛断裂的创伤后，这种稳定功能消失。因此导致腕关节不稳定，通过特定腕关节角度的改变在影像学上可检测到。既然如此，人们可能会认为，连同其他众所周知的原因，腕关节不稳定在舟骨不愈合的发生中会非常重要。然而，在对76例病例进行评估后，仅27.6%的病例发现舟骨不愈合伴有腕关节不稳定。此外，单独对舟骨不愈合进行手术治疗并不能纠正异常的腕关节角度。尽管有此观察结果，但我们认为同时进行韧带修复没有必要，因为在这类病例中骨愈合后几乎没有遗留问题。
