Die klinische Diagnostik des Handgelenks

Schmerzen am Handgelenk sind ein häufiges Problem bei Sportlern und können unterschiedliche Ursachen haben. Welche Strukturen betroffen sind, kann man mit validen Testverfahren herausfinden – vorausgesetzt, man kennt die anatomischen Strukturen und die Biomechanik der Hand.

Publication History

Article published online:
03 May 2022

• Literatur

• 1 Ahn AK, Chang D, Plate A-M. Triangular fibrocartilage complex tears. Bulletin of the NY Hospital for Joint Diseases 2006; 64: 5
• 2 Avery 3 rd DM, Rodner CM, Edgar CM. Sports-related wrist and hand injuries: A review. Journal of Orthopaedic Surgery and Research 2016; 11: 99
• 3 Daneshvar P, Willing R, Pahuta M. et al. Osseous anatomy of the distal radioulnar joint: An assessment using 3-dimensional modeling and clinical implications. The Journal of Hand Surgery 2016; 41: 1071-1079
• 4 Dingle SR, Connolly JF. Hand and wrist injuries in athletes: 20 clinical pearls: These sports injuries run the gamut, and so do the treatments. The Journal of Musculoskeletal Medicine 2003; 20: 394
• 5 Fasen JM, O‘Connor AM, Schwartz SL. et al. A randomized controlled trial of hamstring stretching: Comparison of four techniques. Journal of Strength and Conditioning Research/National Strength & Conditioning Association 2009; 23: 660-667
• 6 Forman TA, Forman SK, Rose NE. A clinical approach to diagnosing wrist pain. American Family Physician 2005; 72: 1753-1758
• 7 Freeland P. Scaphoid tubercle tenderness: A better indicator of scaphoid fractures?. Archives of Emergency Medicine 1989; 6: 46-50
• 8 Fujitani R, Omokawa S, Akahane M. et al. Predictors of distal radioulnar joint instability in distal radius fractures. The Journal of Hand Surgery 2011; 36: 1919-1925
• 9 Iida A, Omokawa S, Akahane M. et al. Distal radioulnar joint stress radiography for detecting radioulnar ligament injury. The Journal of Hand Surgery 2012; 37: 968-974
• 10 Kapandji IA. Funktionelle Anatomie der Gelenke. Stuttgart: Hippokrates; 2001
• 11 Kasapinova K, Kamiloski V. Outcomes of surgically treated distal radial fractures with associated triangular fibrocartilage complex injury. Journal of Hand Therapy: Official journal of the American Society of Hand Therapists 2019; 32: 57-63
• 12 Kataoka T, Moritomo H, Omori S. et al. Pressure and tendon strain in the sixth extensor compartment of the wrist during simulated provocative maneuvers for diagnosing extensor carpi ulnaris tendinitis. Journal of orthopaedic science: Official journal of the Japanese Orthopaedic Association 2015; 20: 993-998
• 13 Kleinman WB. Stability of the distal radioulna joint: Biomechanics, pathophysiology, physical diagnosis, and restoration of function what we have learned in 25 years. The Journal of Hand Surgery 2007; 32: 1086-1106
• 14 LaStayo P, Howell J. Clinical provocative tests used in evaluating wrist pain: A descriptive study. Journal of Hand Therapy: Official journal of the American Society of Hand Therapists 1995; 8: 10-17
• 15 Lehman JD, Krishnan KR, Stepan JG. et al. Prevalence and treatment outcomes of hand and wrist injuries in professional athletes: A systematic review. HSS Journal: The Musculoskeletal Journal of Hospital for Special Surgery 2020; 16: 280-287
• 16 Lester B, Halbrecht J, Levy IM. et al. „Press test“ for office diagnosis of triangular fibrocartilage complex tears of the wrist. Annals of Plastic Surgery 1995; 35: 41-45
• 17 Lindau T, Adlercreutz C, Aspenberg P. Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures. The Journal of Hand Surgery 2000; 25: 464-468
• 18 Mallee WH, Henny EP, van Dijk CN. et al. Clinical diagnostic evaluation for scaphoid fractures: A systematic review and meta-analysis. The Journal of Hand Surgery 2014; 39: 1683-1691 e1682
• 19 May MM, Lawton JN, Blaar PE. Ulnar styloid fractures associated with distal radius fractures: Incidence and implications for distal radioulnar joint instability. The Journal of Hand Surgery 2002; 27: 965-971
• 20 Moritomo H. Anatomy and clinical relevance of the ulnocarpal ligament. Journal of Wrist Surgery 2013; 2: 186-189
• 21 Moriya T, Aoki M, Iba K. et al. Effect of triangular ligament tears on distal radioulnar joint instability and evaluation of three clinical tests: A biomechanical study. The Journal of Hand Surgery, European volume 2009; 34: 219-223
• 22 Nakamura T, Abe K, Nishiwaki M. et al. Medium- to long-term outcomes of anatomical reconstruction of the radioulnar ligament to the ulnar fovea. The Journal of Hand Surgery, European volume 2017; 42: 352-356
• 23 Nakamura T, Yabe Y. Histological anatomy of the triangular fibrocartilage complex of the human wrist. Annals of anatomy = Anatomischer Anzeiger: Official organ of the Anatomische Gesellschaft 2000; 182: 567-572
• 24 Nakamura T, Yabe Y, Horiuchi Y. Functional anatomy of the triangular fibrocartilage complex. J Hand Surg Br 1996; 21: 581-586
• 25 Ogawa T, Tanaka T, Yanai T. et al. Analysis of soft tissue injuries associated with distal radius fractures. BMC Sports Science, Medicine & Rehabilitation 2013; 5: 19
• 26 Omokawa S, Iida A, Kawamura K. et al. A biomechanical perspective on distal radioulnar joint instability. Journal of Wrist Surgery 2017; 6: 88-96
• 27 Onishi T, Omokawa S, Iida A. et al. Biomechanical study of distal radioulnar joint ballottement test. Journal of Orthopaedic Research: Official publication of the Orthopaedic Research Society 2017; 35: 1123-1127
• 28 Ou Yang O, McCombe DB, Keating C. et al. Ulnar-sided wrist pain: A prospective analysis of diagnostic clinical tests. ANZ Journal of Surgery 2021; 91: 2159-2162
• 29 Prosser R, Harvey L, Lastayo P. et al. Provocative wrist tests and MRI are of limited diagnostic value for suspected wrist ligament injuries: A cross-sectional study. Journal of Physiotherapy 2011; 57: 247-253
• 30 Rettig AC. Athletic injuries of the wrist and hand. Part I: Traumatic injuries of the wrist. The American Journal of Sports Medicine 2003; 31: 1038-1048
• 31 Rettig AC. Epidemiology of hand and wrist injuries in sports. Clinics in Sports Medicine 1998; 17: 401-406
• 32 Schmauss D, Pohlmann S, Lohmeyer JA. et al. Clinical tests and magnetic resonance imaging have limited diagnostic value for triangular fibrocartilaginous complex lesions. Arch Orthop Trauma Surg 2016; 136: 873-880
• 33 Sendher R, Ladd AL. The scaphoid. The Orthopedic Clinics of North America 2013; 44: 107-120
• 34 Tay SC, Tomita K, Berger RA. The „ulnar fovea sign“ for defining ulnar wrist pain: An analysis of sensitivity and specificity. The Journal of Hand Surgery 2007; 32: 438-444
• 35 Valdes K, LaStayo P. The value of provocative tests for the wrist and elbow: A literature review. Journal of Hand Therapy: Official journal of the American Society of Hand Therapists 2013; 26: 32-42 quiz 43