Unterarm – Strategien bei fehlgeschlagenen Osteosynthesen

Zusammenfassung

Der Unterarm ist als eine gelenkige Verbindung zwischen Ellenbogen und Handgelenk zu begreifen. Eine osteosynthetische Versorgung an Radius und Ulna bedarf eines profunden anatomischen Verständnisses, um die Funktion bestmöglich zu erhalten. Bei fehlgeschlagenen Osteosynthesen ist die Herausforderung ungleich höher. Ziel dieses Artikels ist es, Strategien vorzustellen, die im Falle einer Pseudarthrose, Infektion, bei speziellen Frakturformen oder Malunion nach primärer Osteosynthese zur Verfügung stehen.

Abstract

Profound anatomical knowledge is mandatory in the fixation of forearm fractures in order to avoid loss of function, as the radius and ulna can be seen as a complex anatomical and functional unit between the elbow and the wrist. In case of necessary revision of fractures, the challenge can be even greater. The goal of this article is to introduce strategies in dealing with postoperative pseudarthrosis, infection, specific fracture patterns or malunion. Corrective operations of the forearm demand a detailed anatomical and functional knowledge of all bony and ligamentous structures. The most common indication for revision surgery is pseudarthrosis. Local debridement combined with structural augmentation and stable plate fixation is necessary in order to achieve bone healing. All other possible complications of primary osteosynthesis (malunion, special fracture patterns) demand an individual patient-centered approach.

Schlüsselwörter

Unterarm - Fraktur - Revision - OP-Strategien

Key words

forearm - fracture - revision - surgical strategies

Publication History

Article published online:
03 December 2019

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