Pseudarthrosen am Femur inklusive Korrekturosteotomien

Einleitung

Pseudarthrosen am Femur stellen komplexe Folgezustände nach Fraktur dar. Dies bedingt eine sozioökonomische Herausforderung sowohl für den Patienten selbst, seinen behandelnden Chirurgen als auch das Gesundheitssystem. Risiken für eine Pseudarthrose am Femur stellen u. a. Faktoren dar, die bereits im Rahmen der primären Verletzung begründet sein können, wie ein durch das Trauma assoziierter Weichteilschaden bei offener Fraktur, eine Verletzung im Rahmen eines Polytraumas (z. B. mit Schädel-Hirn-Trauma) sowie Nebenerkrankungen des Patienten wie Diabetes mellitus oder ausgeprägter Nikotinabusus. Auch systemische Erkrankungen oder Medikamenteneinnahme (z. B. Statine) nehmen Einfluss auf die Knochenheilung. Um die richtige Behandlungsstrategie zu wählen, bedarf es hoher chirurgischer Expertise und Erfahrung: Die Behandlung erfordert eine ausführliche klinisch-radiologische sowie laborchemische Diagnostik sowie biomechanisches und biologisches Verständnis der knöchernen Situation. Nur so kann eine zügige knöcherne Ausheilung der Pseudarthrose am Femur mit möglichst geringer Zahl an Revisionseingriffen erreicht werden.

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