Frakturen des Fußes beim älteren Patienten – was ist anders?

Zusammenfassung

Im Gegensatz zu Frakturen des oberen Sprunggelenkes sind Frakturen des Fußes keine typischen Verletzungen des älteren Patienten. Die aktuelle Literatur liefert nur wenige Erkenntnisse über die Besonderheiten oder Unterschiede zum jüngeren Patienten. Dennoch sind Verletzungen des Fußes nicht selten in dieser Altersgruppe, zum einen bedingt durch Risikofaktoren wie eine osteoporotische Knochenstruktur und Sturzneigung, zum anderen bedingt durch den mittlerweile hohen Aktivitätslevel der Patienten. Die Behandlung stellt aufgrund der oftmals kompromittierten Weichteilverhältnisse, der schlechten Knochenqualität, vorbestehender Deformitäten sowie degenerativer Veränderungen und der häufig nicht einzuhaltenden Teilbelastung im Rahmen der Behandlung eine Herausforderung dar. Im Gegensatz zum jüngeren Patienten finden sich beim älteren andere Frakturmorphologien sowie therapeutisch andere Gesichtspunkte aufgrund von Komorbiditäten. Wie auch beim jungen Patienten steht die Wiederherstellung der Funktion und Mobilität an oberster Stelle des therapeutischen Regimes.

Abstract

In contrast to ankle fractures of the foot are no typical fractures in the elderly. In the current literature only a few special features or differences of these fractures in contrast to younger patients are published. Nevertheless injuries of the foot in the elderly are not so rare, on the one hand because of risk factors like osteorotic bone quality and tendency to fall, on the other hand because of the increasing activity level in these patients. The treatment is challenging because of compromised soft tissue, bad bone quality, existing deformities and degenerative changes and often inability of partial weight bearing. In contrast to younger patients there are differences in fracture morphology and treatment options with regard to comorbidities. In line with the concepts in younger patients the goals of treatment are restoration of function and mobility.

• Literatur

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