Azetabulumfrakturen: Komplikationen und Endoprothetik

S. C. Herath; J. H. Holstein; A. Pizanis; T. Pohlemann

doi:10.1055/s-0034-1382862

Zeitschrift für Orthopädie und Unfallchirurgie, Table of Contents

Z Orthop Unfall 2014; 152(4): 399-413
DOI: 10.1055/s-0034-1382862

Refresher Orthopädie und Unfallchirurgie

Georg Thieme Verlag KG Stuttgart · New York

Azetabulumfrakturen: Komplikationen und Endoprothetik

Fractures of the Acetabulum: Complications and Joint Replacement

S. C. Herath

Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes – UKS, Homburg/Saar

,

J. H. Holstein

Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes – UKS, Homburg/Saar

,

A. Pizanis

Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes – UKS, Homburg/Saar

,

T. Pohlemann

Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes – UKS, Homburg/Saar

› Author Affiliations

Abstract

Zusammenfassung

Azetabulumfrakturen nehmen als Gelenkbrüche eine Sonderstellung unter den Beckenfrakturen ein. Schon durch die Tatsache, dass sie meist durch Einwirkung großer Kraft auf den Körper entstehen, und aufgrund ihrer Lokalisation in einer anatomisch komplizierten Region ist mit einer erhöhten Rate an Komplikationen zu rechnen. Neben den allgemeinen und perioperativen Komplikationen spielen auch Spätfolgen, insbesondere die posttraumatische Arthrose, eine große Rolle. Sowohl die primäre operative Rekonstruktion des Azetabulums als auch ein eventuell notwendiger endoprothetischer Gelenkersatz stellen hohe Anforderungen an die diagnostischen und operativen Fähigkeiten des behandelnden Arztes. Die Kenntnis der für die verschiedenen Frakturtypen und Operationstechniken spezifischen Risiken ist essenziell für eine erfolgreiche Therapie. Aufgrund der im Vergleich zur primären Hüftendoprothetik deutlich schlechteren Langzeitergebnisse ist bei Azetabulumfrakturen, unabhängig vom Patientenalter, wann immer möglich eine operative Rekonstruktion anzustreben.

Abstract

Acetabular fractures assume a special role amongst the fractures of the pelvis, because they involve a major weight-bearing joint. As those fractures mostly result from exposure to great force, and because of their location in an anatomically complex region, a high rate of complications has to be anticipated. Besides general and perioperative complications long-term consequences, especially post-traumatic arthrosis, are relevant problems when it comes to treating fractures of the acetabulum. The primary reconstruction of the acetabulum, as well as a possibly necessary prosthetic replacement of the hip joint, makes high demands on the diagnostic and operative capabilities of the attending physician. Exact knowledge of the specific risks and pitfalls for each type of fracture and for the specific surgical techniques is crucial for a successful treatment. Due to the much worse long-term outcome when compared to primary total hip replacement in patients with osteoarthritis, acetabular fractures should, regardless of the patient’s age, whenever possible be treated by operative reconstruction.

Key words

Azetabulumfraktur - Beckenfraktur - Komplikationen - Endoprothetik - Osteosynthese - Rekonstruktion

Key words

acetabular fracture - pelvic fracture - complications - endoprosthetic replacement - osteosynthesis - reconstruction

Full Text

References

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