Die differenzierte Therapie karpaler Bandverletzungen

Zusammenfassung

Karpale Bandverletzungen sind komplexe Krankheitsbilder, die zu einer Instabilität der Handwurzel mit frühzeitiger Arthroseentwicklung führen. Am häufigsten ist dabei das skapholunäre Band zwischen Kahnbein und Mondbein betroffen. Diese Verletzungen werden nach wie vor häufig übersehen, müssen aber stadiengerecht diagnostisch aufgearbeitet und therapiert werden, um Spätfolgen zu vermeiden. Vor allem für die chronische skapholunäre Instabilität nach länger zurückliegenden Bandverletzungen sind zahlreiche konkurrierende Therapieoptionen beschrieben, die jedoch alle die ursprüngliche Biomechanik nicht wiederherstellen können. Der Artikel gibt einen Überblick über die differenzierte Diagnostik und Therapie der skapholunären Bandverletzung.

Abstract

Injuries of the carpal ligaments are complex entities leading to carpal instability and, subsequently, premature degenerative arthritis of the radiocarpal joint. In most cases, the scapholunate ligament between the scaphoid and lunate bones is affected. Even today, injuries of these ligaments are often missed and treatment is delayed. However, scapholunate ligament injuries require meticulous diagnostic workup and treatment depending on injury stages to avoid late complications. In particular, there are a large number of treatment options for established, chronic scapholunate instability secondary to past ligament injuries. However, none of them has been proven to properly restore carpal kinematics. This article provides a brief overview of the diagnostic workup and treatment of scapholunate ligament injuries.

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