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DOI: 10.1055/a-1125-6193
Lösungsmöglichkeiten bei fehlgeschlagenen Osteosynthesen – Humerusschaft
Zusammenfassung
Bei der operativen Therapie von Humerusschaftfrakturen finden sowohl die intramedulläre Nagel- als auch die Plattenosteosynthese regelhaft Anwendung. Für beide Verfahren kann zwischen Früh- und Spätkomplikationen unterschieden werden. Bei der Nagelosteosynthese werden im frühen postoperativen Verlauf häufiger periimplantäre Frakturen etwa am Tuberculum majus oder im Bereich der Fossa olecrani beobachtet. Bei der Plattenosteosynthese hingegen kommt es häufiger zum Repositionsverlust mit sekundärer Dislokation sowie zu Affektionen des Nervus radialis. Pseudarthrosen als klassische Spätfolge zeigen sich häufiger nach der Nagelosteosynthese. Früh- und Spätinfekte im Bereich des Humerusschafts sind insgesamt selten. In der vorliegenden Arbeit werden Lösungsmöglichkeiten bei fehlgeschlagenen Osteosynthesen des Humerusschafts anhand edukativer Fallbeispiele und der aktuellen Literatur dargestellt.
Abstract
For the operative treatment of humeral shaft fractures both intramedullary nailing and plate fixation are commonly used. For both types of fixation early and late complications can be observed. After intramedullary nailing periimplantary fractures, especially around the greater tuberosity and the fossa olecrani occur. Following plate fixation however, loss of reduction and palsy of the radial nerve are more frequently observed. Non-unions depict typical late complications with higher rates after intramedullary nailing. Early and late infections of humeral shaft fracture fixations are rare. In this manuscript solutions for failed fixation of humeral shaft fractures are presented with educative cases and the current literature.
Schlüsselwörter
Pseudarthrose - periimplantäre Fraktur - Infekt - Repositionsverlust - sekundäre DislokationKey words
non-union - periimplantary fracture - infection - loss of reduction - secondary displacementPublication History
Article published online:
28 May 2020
Georg Thieme Verlag KG
Stuttgart · New York
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