Frakturversorgung im Alter

Zusammenfassung

Osteoporose verursacht nicht nur Frakturen – sie erschwert auch deren Behandlung. Die gleichen Faktoren, die die Frakturentstehung begünstigen (rarefizierte Knochenmikroarchitektur, ausgedünnte Kortikalis sowie weitere Osteoporoserisikofaktoren), erschweren auch deren traumatologische Behandlung. Allerdings wird davon ausgegangen, dass Frakturen von Osteoporosepatienten normal heilen können – wenn sie adäquat fixiert sind. In den vergangenen Jahren wurden eine Reihe neuer Lösungsansätze zu Diagnostik und Therapie von Frakturen im osteoporotischen Knochen entwickelt. Durch neue, adaptierte Diagnostik wird die Wahl des geeigneten Osteosyntheseverfahrens erleichtert. Angepasste Designs, Augmentation der Knochen/Implantat-Oberfläche und systemische Mitbehandlung können die Frakturversorgung im osteoporotischen Knochen verbessern. Die Behandlung sollte interdisziplinär im Team mit Geriatern und Internisten erfolgen, um eine niedrige Mortalität sowie eine schnelle Rehabilitation zu erreichen.

Summary

Osteoporosis not only induces fractures, but makes their treatment more difficult. The same factors that promote the occurrence of fractures (rarefaction of bone micro-architecture and cortical thinning, as well as further osteoporosis risk factors) also complicate their traumatological treatment. However, it is assumed that fractures in osteoporosis patients can heal normally when adequately fixated. In recent years a range of new approaches for the diagnostic investigation and therapy of fractures in osteoporotic bone has been developed. Through new, adapted diagnostics the choice of the appropriate osteosynthesis treatment will be made easier. Adapted designs, augmentation of the bone/ implant interface and systemic treatment can improve fracture care of osteoporotic bone. Treatment should be interdisciplinary and carried out in a team with geriatricians and internists to achieve a lower mortality as well as a more rapid rehabilitation.

Schlüsselwörter

Osteoporose - Fraktur - Osteosynthese

Keywords

Osteoporosis - fracture - osteosynthesis

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