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Osteosynthese International 2001; 9(3): 128-132
DOI: 10.1055/s-2001-17058
Originalarbeit

J.A.Barth Verlag in Medizinverlage Heidelberg GmbH & Co.KG

Indikation zur prothetischen Versorgung bei medialer Schenkelhalsfraktur

Indication for prosthetic hip replacement in case of femoral neck fractureCh. Fialka, V. Vécsei
  • Universitätsklinik für Unfallchirurgie (Vorstand: Prof. Dr. V. Vécsei), AKH Wien
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Publikationsverlauf

Publikationsdatum:
12. September 2001 (online)

    Lizenzen und Reprints

Zusammenfassung

Die vorliegende Arbeit ist eine Literaturübersicht zur Frage der Indikation zum prothetischen Ersatz bei vorliegender medialer Schenkelhalsfraktur. Basierend auf den mechanischen Berechnungen von Pauwels und den Beobachtungen von Garden hat sich in den letzten Jahrzehnten eine Literaturdiskussion zur korrekten Wahl des Implantates entsponnen, die ihren Endpunkt noch nicht erreicht hat. Pro und Contra der Hemiprothese auf der einen, bzw. der Totalendoprothese auf der anderen Seite, die Frage ob in zementierter Technik oder zementfrei, ebenso wie die Grenzen der Indikation und die Ergebnisse hüftkopferhaltender Techniken werden aufgezeigt. Ein therapeutischer Algorithmus wird vorgestellt, der in der Entscheidungsfindung unterstützen helfen soll.

Indication for prosthetic hip replacement in case of femoral neck fracture

Summary

This paper is a literature review about the indication for prosthetic hip replacement in case of femoral neck fracture. Based on the mechanical model of Pauwels and the findings of Garden, there is a discussion in the literature about the correct indication for the different implants, like total- or hemi hip prosthesis, as well as about primary osteosynthesis, that has not come to a final conclusion until today. Pros and Cons for hemi arthroplasty on one hand, and total arthroplasty on the other hand, cemented or noncemented techniques are discussed, problems of osteosynthetic procedures are demonstred. Finaly a therapeutical algorithm is presented, that could be helpful in decision making.

Résumé

Le présent travail est une revue de la littérature concernant la question des indications du remplacement prothétique des fractures cervicales du fémur. Une discussion non suivie de conclusion basée sur les calculs mécaniques de Pauwels et les observations de Garden s'est développée ces dernières années concernant le choix correct de l'implant. Les arguments pour ou contre l'hémiprothèse d'une part, par rapport à la prothèse totale cimentée ou non d'autre part, ainsi que les limites des indications et les résultats des techniques conservant la tête du fémur sont énumérées. Un algorithme thérapeutique est proposé qui devrait aider à la décision.

Resumen

Este trabajo es una revisión de la literatura sobre la indicación del remplazo protésico en el caso de la fractura del cuello femoral. En base al modelo mecánico de Pauwels y los hallazgos de Garden, hay discusión en la literatura acerca de la correcta indicación para los diferentes implantes, prótesis total, hemiartroplastia y osteosíntesis primaria, que no ha llegado a definirse. Los pros y los contras de la hemiartroplastia por un lado y de la artroplastia total por otro, y de las técnicas cementadas y no cementadas son discutidos y los problemas de los procedimientos de osteosítesis son demostrados. Finalmente, un algoritmo terapéutico es presentado, el que podría ser de ayuda en la decisión.

Schlüsselwörter

Schenkelhalsfraktur - Trauma - Hemiprothese - Totalendoprothese - Knochenzement

Key words

Femoral neck fracture - trauma - hemiarthroplasty - total hip prosthesis - bone cement

Mots clés

Fracture du col du fémur - hémiprothèse - prothèse totale - ciment osseux

Palabras claves

Fractura del cuello femoral - trauma - hemiartroplastia - prótesis total de cadera - cemento óseo

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Dr. Christian Fialka

Universitätsklinik für Unfallchirurgie
AKH Wien

Währinger Gürtel 18-20

A-1090 Wien