Das hintere Kantenfragment

Sprunggelenkfrakturen mit Beteiligung der Hinterkante der distalen Tibia gehen mit einer schlechteren Prognose einher. In den letzten Jahren erfolgte ein Paradigmenwechsel bez. Diagnostik und Therapie. Insbesondere sorgte die Bildgebung mittels CT und anschließender 3-D-Rekonstruktion sowie die daraus resultierenden CT-basierten Klassifikationssysteme für ein besseres Verständnis der Frakturmorphologie des hinteren Kantenfragmentes. Dies führt zu einem verbesserten Verständnis der Verletzung und zu neuen Versorgungsstrategien. Nicht allein die Größe des hinteren Kantenfragmentes, sondern die Beteiligung der Incisura fibulae, die anatomische Reposition der Gelenkkongruenz der hinteren Tibiakante, intermediäre Fragmente und die Syndesmosenstabilität bilden heute wichtige Indikatoren für die operative Versorgungsstrategie und Langzeitprognose. Der direkte Zugang kann die Verletzung direkt adressieren, reduziert die postoperativen Komplikationen und verbessert die Langzeitergebnisse.

Schlüsselwörter

hinteres Kantenfragment - posteriores malleoläres Fragment - Sprunggelenkfraktur - Syndesmose - trimalleolär

Keywords

posterior malleolus fracture - posterior malleolar fragment - ankle fracture - syndesmosis - trimalleolar

Publication History

Article published online:
29 April 2024

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