Die Anatomie des ulnokarpalen Komplexes

Hm, Schmidt

doi:10.1007/s00132-004-0665-9

Cited by 17 publications

(4 citation statements)

References 34 publications

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“…Legfőbb szerepe a radialis és ulnaris deviato. Radial deviatióban a mozgástartomány 60%-át, ulnar deviatióban a mozgás 86%-át biztosítja (13,24,29).…”

Section: Bevezetés a Csukló Mozgásának Jelentőségeunclassified

Négyes arthrodesissel elért eredményeink a SNAC és a SLAC okozta csukló arthrosisok megoldásában

Ferenczy,

Hetthéssy

2023

MTO

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A csuklót érő hatások esetén gyakran találkozhatunk a proximalis kéztőcsontsorban található sajkacsontot vagy környezetét érintő sérülésekkel. Az itt található összetett biomechanikai rendszer bármilyen okból történő megszakadása a csontok közötti konstrukció felbomlásához vezet, ami az arthrotikus folyamatok megindulását is magába foglalja. A sajkacsont törése vagy a scapholunaris szalag sérülése során létrejövő szerkezeti instabilitás két speciális arthrosis menetet hoz létre: a Scaphoid Nonunion Advanced Collapse (SNAC) és Scapholunate Advanced Collapse (SLAC) wrist-et. Mindkét deformitás esetében számos műtéti technika áll rendelkezésre, a különböző stádiumoktól függően. A műtéti megoldások közül lehetőleg kerülendő a teljes arthrodesis, mert a betegek számára a mozgástartomány teljes hiánya az életminőség romlásához vezet. Éppen ezért a cél mindig a mozgásmegtartó műtétek előtérbe helyezése, amelyek közé a négyes arthrodesis is tartozik. A 4CF alternatíva lehet a SNAC és SLAC wrist II. és III. stádiumában. A Semmelweis Egyetem Ortopédiai Klinika és az Országos Sportegészségügyi Intézet Sportsebészeti Osztály beteganyagának, illetve a szakirodalomban található eredmények alapján a négyes arthrodesis eredményeit vizsgáltuk a mindennapi tevékenységekhez, munkához szükséges mozgástartomány, erő és a funkcionális kézpanaszok tekintetében, releváns kérdőívek és mérések elvégzésével.

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“…Legfőbb szerepe a radialis és ulnaris deviato. Radial deviatióban a mozgástartomány 60%-át, ulnar deviatióban a mozgás 86%-át biztosítja (13,24,29).…”

Section: Bevezetés a Csukló Mozgásának Jelentőségeunclassified

Négyes arthrodesissel elért eredményeink a SNAC és a SLAC okozta csukló arthrosisok megoldásában

Ferenczy,

Hetthéssy

2023

MTO

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Section: Introductionmentioning

confidence: 99%

“…The triangular fibrocartilage complex (TFCC) is an important component involved in distal radioulnar joint (DRUJ) stability [ 1 , 2 , 3 ]. TFCC injury causes ulnar-sided wrist pain, clicks, and a decrease in a power grip, and it can result in remarkable wrist disability and impaired hand function [ 3 ]. The TFCC consists of the articular disc, dorsal and volar radioulnar ligaments, meniscus homologue, ulnar collateral ligament, and sheath of the extensor carpi ulnaris (ECU) [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Motion Analysis of the Extensor Carpi Ulnaris in Triangular Fibrocartilage Complex Injury Using Ultrasonography Images

Tanaka

Inui

Mifune

et al. 2022

Sensors

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The subsheath of the extensor carpi ulnaris (ECU) tendon, a component of the triangular fibrocartilage complex (TFCC), is particularly important as it dynamically stabilizes the distal radioulnar joint. However, the relationship between TFCC injury and ECU dynamics remains unclear. This study aimed to analyze ECU movement and morphology using ultrasonography (US) images. Twenty wrists of patients with TFCC injury, who underwent TFCC repair, were included in the injury group, and 20 wrists of healthy volunteers were in the control group. For static image analysis, curvature and linearity ratios of the ECU in US long-axis images captured during radioulnar deviation were analyzed. For dynamic analysis of the ECU, the wrist was moved from radial deviation to ulnar deviation at a constant speed, and the velocity of the tendon was analyzed using particle image velocimetry. The static analysis showed that the ECU tendon was more curved in ulnar deviation in the injury group than in the control group, and the dynamic analysis showed that only vertical velocity toward the deep side during ulnar deviation was higher in the injury group. These results suggest that TFCC injury caused ECU curvature during ulnar deviation and increased the vertical velocity of the ECU during wrist deviation.

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“…The triangular fibrocartilage complex (TFCC) is a collection of anatomically related structures which interconnect the carpus and the distal ends of the radius and ulna. Schmidt (2004) refers to it as the ‘ulnocarpal complex’ in his authoritative account of the gross anatomy of the wrist and lists its components as the triangular (ulnocarpal) disc itself, a meniscal homologue, ligaments linking the ulna to the radius and to several carpal bones, the prestyloid recess and the tendon sheath of extensor carpi ulnaris. It is uniquely a hominid feature which ensures that the lower end of the ulna does not articulate directly with the carpal bones.…”

Section: Introductionmentioning

confidence: 99%

An immunohistochemical study of the triangular fibrocartilage complex of the wrist: regional variations in cartilage phenotype

et al. 2007

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The triangular fibrocartilage complex (TFCC) transmits load from the wrist to the ulna and stabilizes the distal radioulnar joint. Damage to it is a major cause of wrist pain. Although its basic structure is well established, little is known of its molecular composition. We have analysed the immunohistochemical labelling pattern of the extracellular matrix of the articular disc and the meniscal homologue of the TFCC in nine elderly individuals (age range 69 -96 years), using a panel of monoclonal antibodies directed against collagens, glycosaminoglycans, proteoglycans and cartilage oligomeric matrix protein (COMP). Although many of the molecules (types I, III and VI collagen, chondroitin 4 sulphate, dermatan sulphate and keratan sulphate, the oversulphated epitope of chondroitin 6 sulphate, versican and COMP) were found in all parts of the TFCC, aggrecan, link protein and type II collagen were restricted to the articular disc and to entheses. They were thus not a feature of the meniscal homologue. The shift in tissue phenotype within the TFCC, from a fibrocartilaginous articular disc to a more fibrous meniscal homologue, correlates with biomechanical data suggesting that the radial region is stiff and subject to considerable stress concentration. The presence of aggrecan, link protein and type II collagen in the articular disc could explain why the TFCC is destroyed in rheumatoid arthritis, given that it has been suggested that autoimmunity to these antigens results in the destruction of articular cartilage. The differential distribution of aggrecan within the TFCC is likely to be reflected by regional differences in water content and mobility on the radial and ulnar side. This needs to be taken into account in the design of improved MRI protocols for visualizing this ulnocarpal complex of the wrist.

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Die Anatomie des ulnokarpalen Komplexes

Cited by 17 publications

References 34 publications

Négyes arthrodesissel elért eredményeink a SNAC és a SLAC okozta csukló arthrosisok megoldásában

Négyes arthrodesissel elért eredményeink a SNAC és a SLAC okozta csukló arthrosisok megoldásában

Motion Analysis of the Extensor Carpi Ulnaris in Triangular Fibrocartilage Complex Injury Using Ultrasonography Images

An immunohistochemical study of the triangular fibrocartilage complex of the wrist: regional variations in cartilage phenotype

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