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OP-Journal 2012; 28(2): 160-165
DOI: 10.1055/s-0032-1315337
Georg Thieme Verlag KG Stuttgart · New York

Indikationen, chirurgische Technik und Ergebnisse der winkelstabilen Plattenosteosynthese bei periprothetischen Frakturen am Kniegelenk

Sven Märdian
,
Phillip Schwabe
,
Norbert P. Haas
,
Klaus-Dieter Schaser
Further Information

Publication History

Publication Date:
03 December 2012 (online)

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Zusammenfassung

Die Inzidenz periprothetischer Frakturen des Kniegelenks (Femur, Tibia, Patella) steigt mit steigender Implantationsfrequenz von Knietotalendoprothesen stetig an. In Abhängigkeit von der Lokalisation können neben reinen Traumata auch implantatspezifische Parameter und Implantatlockerungen ursächlich sein. Es liegen inzwischen exakte Klassifikationen der periprothetischen Frakturen nach Knie-TEP für die 3 Lokalisationen an Femur, Tibia und Patella vor, die die Basis für ein differenziertes Therapiekonzept darstellen. Die modernen winkelstabilen Plattenfixateure als eine der vielfältigen Möglichkeiten verfügbarer Behandlungsoptionen stellen eine valide Therapieoption dar. Trotzdem weisen die Behandlungsergebnisse hohe Raten an Komplikationen auf, was nur durch die adäquate Analyse der Frakturursachen und die Umsetzung in ein individuell optimiertes, weichteilschonendes Behandlungskonzept zu beheben ist. Hierdurch kann eine vergleichsweise identische funktionelle Wiederherstellung des Patienten wie vor dem Frakturereignis erzielt werden.

Indications, Surgical Technique and Outcome of Angular Stable Plates in Periprosthetic Fractures of the Knee

The incidence of periprosthetic fractures of the knee (femur, tibia, patella) increases with the increasing frequency of total arthroplasties of the knee. Depending on the localisation the causes can be not only purely traumatic but also due to implant-specific parameters and implant loosenings. In the meantime there is an exact classification of the periprosthetic fractures after total knee arthroplasty for the three localisations on the femur, tibia, and patella that provides a basis for differentiated therapeutic concepts. Modern, angular stable plate fixation methods, as one of the many treatment options, represent a valid therapeutic choice. Even so, the treatment results exhibit a high rate of complications that can only be avoided by an adequate analysis of the fracture cause and the application of an individually optimised, soft-tissue sparing treatment concept. In this way a more or less complete restoration of the functional state existing prior to the fracture can be achieved.

 

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