Pseudarthrosen am Unterarm

Zusammenfassung

Unterarmfrakturen treten häufig auf und werden regelhaft operativ versorgt. Für gute funktionelle Ergebnisse müssen Unterarmfrakturen anatomisch reponiert werden, was im Falle einer Revision weiter erschwert wird. Daher ist eine ausbleibende Frakturheilung bei diesen Verletzungen besonders problematisch.

Die operative Therapie dieser Pseudarthrosen besteht aus einem Debridement und der stabil osteosynthetischen Versorgung. In der Regel ist zudem eine Augmentation des knöchernen Defekts erforderlich: Kleinere Defekte können erfolgreich mit einer Spongiosaplastik behandelt werden, für größere Defekte werden vaskularisierte und nicht vaskularisierte Späne verwendet. In seltenen Ausnahmen können auch Reserveverfahren wie der Segmenttransport oder das Masquelet-Verfahren Anwendung finden. Mit diesen Strategien ist meist eine erfolgreiche Ausheilung der Pseudarthrose möglich. Ziel dieses Artikels ist die Häufigkeit von Pseudarthrosen am Unterarm und Therapiestrategien zusammenzufassen.

Abstract

Fractures of the forearm are common and regularly treated operatively. For a satisfactory functional outcome, these fractures require an anatomical reduction which can be particularly difficult in revision surgery. Therefore, operative treatment of non-unions is especially challenging in these injuries.

Surgical treatment of a forearm non-union consists of a debridement and a stable osteosynthesis. The resulting defect regularly needs augmentation: Smaller defects can be treated using cancellous bone grafting, larger defects are treated with vascularized and non-vascularized grafts. Callus distraction or the Masquelet technique are less common and can be used as a fallback. With use of these procedures, a successful healing of a non-union can usually be achieved. Aim of this article is to summarize the frequency of forearm non-unions and to present therapeutic strategies.

Schlüsselwörter

Pseudarthrose - Unterarm - obere Extremität

Key words

nonunion - forearm - upper extremity

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