Kapandji A
Orthopade. 1986 Apr;15(2):60-73.
During the last decade the classical idea of the rigid carpal block was abandoned in favour of the "carpus of variable geometry". The basic advantage of this new concept is the presumption that the proximal carpal row can be regarded as an intercalated structure, and the idea of the "useful distance" between the forearm socket and the distal carpal row. This "useful distance" can be filled up by elementary movement of the bones of the first carpal row. This directly leads to the concept of the "internal coherence of the carpus" and "variable geometry". The internal components of associated movements in the carpal region are described. Finally, the self-blocking system, the associated movement of the bones of the first carpal row caused by the interosseous ligaments, and the new definition of carpal instability are also discussed.
在过去十年中,传统的僵硬腕骨阻滞概念被摒弃,转而支持“几何形状可变的腕骨”这一概念。这一新概念的基本优势在于,假定近端腕骨排可被视为一个插入结构,以及前臂窝与远端腕骨排之间存在“有效距离”这一观点。这个“有效距离”可通过第一腕骨排骨骼的基本运动来填充。这直接引出了“腕骨内部连贯性”和“可变几何形状”的概念。文中描述了腕骨区域相关运动的内部组成部分。最后,还讨论了自阻滞系统、骨间韧带引起的第一腕骨排骨骼的相关运动以及腕骨不稳定的新定义。