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OP-Journal 2019; 35(03): 330-337
DOI: 10.1055/a-0898-4198
Fachwissen
Georg Thieme Verlag KG Stuttgart · New York

Tibiapseudarthrosen

Nonunion of the Tibia
Martin Henri Hessmann
,
Katharina Körblein
Further Information

Publication History

Publication Date:
19 November 2019 (online)

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Zusammenfassung

Pseudarthrosen gehören zu den häufigsten Komplikationen nach Tibiaschaftfrakturen. Hypertrophe Pseudarthrosen erfordern eine Verbesserung der biomechanischen Stabilitätseigenschaften der Osteosynthese. Der Verfahrenswechsel mit Umnagelung und die augmentierende Plattenosteosynthese bieten verlässlich gute Ausheilungsergebnisse. Bei der atrophen Pseudarthrose sind zusätzliche Maßnahmen zur Verbesserung der Biologie erforderlich. Infektpseudarthrosen sind besonders anspruchsvoll und erfordern die Therapie sowohl des Infektes als auch der Frakturheilungsstörung. Die sorgfältige Analyse der Ausgangssituation und der Ursachen der Frakturheilungsstörung sowie die konsequente Therapie führen zu hohen Ausheilungsraten.

Abstract

Nonunion is a common complication after tibia shaft fractures. Hypertrophic nonunion requires an improvement of biomechanical stability. Exchange nailing and augmenting plate fixation leads to reliably good fracture healing results. Atrophic nonunion requires additional measures in order to improve local biology. Infection nonunion represents a challenging situation that requires the treatment of both the infection and the fracture healing problem. Careful analysis of the ethiology of the fracture healing disturbance and a consequent treatment regimen leads to reliably high healing rates.

Schlüsselwörter

Fraktur - Tibia - Pseudarthrose - Nagelung - Verfahrenswechsel - RIA - Osteomyelitis

Key words

fracture - tibia - nonunion - nailing - exchange nailing - RIA - osteomyelitis
 

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