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OP-Journal 2020; 36(02): 89-100
DOI: 10.1055/a-1044-3934
Fachwissen

Lösungsmöglichkeiten bei fehlgeschlagenen Osteosynthesen an Schulter und Schultergürtel

Revision and Salvage Procedures after Failure of Osteosynthesis at the Shoulder and Shoulder Girdle
Michael Plecko
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Zusammenfassung

Die Behandlung von fehlgeschlagenen Osteosynthesen an Schulter und Schultergürtel stellt oft eine große Herausforderung an das Behandlungsteam dar. Am häufigsten gibt es Fehlschläge am proximalen Humerus und am Schlüsselbein, die eine auf den Einzelfall abgestimmte individuelle Behandlung erfordern. Neben der konservativen symptomorientierten Therapie sind in manchen Fällen die Reosteosynthese mit oder ohne Knochenaugmentation bzw. Spongiosaplastik oder der endoprothetische Ersatz zu bevorzugen. Wichtig für die Erzielung eines guten Ergebnisses ist neben einer exakten Ursachenanalyse ein frühzeitiges Einschreiten, um Vernarbungen, Kontrakturen bzw. fortgeschrittene Muskelatrophien zu vermeiden. Bei adäquater rechtzeitiger Therapie kann i. d. R. ein zufriedenstellendes Ergebnis erzielt werden.

Abstract

Treatment of failed osteosynthesis at the shoulder or shoulder girdle is often challenging. Failures are most commonly encountered after osteosyntheses of the proximal humerus and the clavicle. A case by case decision, focusing at patientsʼ demands is mandatory. Conservative management, as well as, in some cases, revision surgery, respectively reosteosynthesis with or without augmentation using cancellous bone grafts or endoprosthetic replacement, is recommended. It is very important to perform a careful analysis of each case and if needed an early intervention to avoid severe scar formation or muscle atrophy. If the applied treatment concept is adequate and conducted early enough, satisfying results may be expected.

Schlüsselwörter

Implantatversagen - Pseudarthrose - Reosteosynthese - Revisionsprothese

Key words

implant failure - nonunion - revision osteosynthesis - revision endoprosthesis


Publication History

Article published online:
06 February 2020

Georg Thieme Verlag KG
Stuttgart · New York

 

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