Deglmann C J
MünchenHand - Privatpraxis für Hand- und Handgelenkchirurgie, Marienplatz 21, 80333, München, Deutschland.
Deutsches Zentrum für Obere Extremität, Effnerstr. 38, 81925, München, Deutschland.
Orthopadie (Heidelb). 2024 Jun;53(6):463-476. doi: 10.1007/s00132-024-04502-w. Epub 2024 May 24.
The term osteoarthritis (OA) of the wrist can be used as an umbrella term for various, often independent areas of OA, as the wrist is made up of several joints. Radiocarpal OA often occurs after untreated ligament injuries, incorrectly healed bone fractures in the carpus or after radius fractures involving the joint. A typical sequence of propagation is known for radiocarpal OA following scapholunate (SL) insufficiency or scaphoid pseudarthrosis. Other causes include inflammation, crystal deposits or bone necrosis. Ulnocarpal arthrosis occurs posttraumatically or primarily when there are differences in levels between the ulna and radius. When treating wrist arthrosis, after conservative measures have been exhausted a surgical procedure should be chosen that enables the best possible load-bearing and residual mobility, considering the surgical risks and individual requirements. During salvage operations, the defective cartilage areas are either fused directly or eliminated using appropriate diverting partial fusions and resection arthroplasty. An accurate analysis of the affected zones is crucial for selecting an appropriate intervention.
腕关节骨关节炎(OA)这一术语可作为各种通常相互独立的OA区域的统称,因为腕关节由多个关节组成。桡腕关节OA常发生在韧带损伤未治疗、腕骨骨折愈合不良或累及关节的桡骨骨折之后。舟月骨(SL)不稳或舟状骨假关节后桡腕关节OA有典型的传播序列。其他原因包括炎症、晶体沉积或骨坏死。尺腕关节病创伤后发生,或主要在尺骨和桡骨长度不同时出现。治疗腕关节病时,在保守治疗措施用尽后,应选择一种手术方法,在考虑手术风险和个体需求的情况下,尽可能实现最佳的负重和保留残余活动度。在挽救手术中,有缺陷的软骨区域要么直接融合,要么通过适当的转向部分融合和切除关节成形术消除。准确分析受影响区域对于选择合适的干预措施至关重要。