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Z Orthop Unfall 2021; 159(02): 217-231
DOI: 10.1055/a-1042-0567
CME-Fortbildung

Frakturen des distalen Radius

Fractures of the Distal Radius
Christian Konrads
,
Christoph Gonser
,
Christian Bahrs
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Zusammmenfassung

Die distale Radiusfraktur ist die häufigste Fraktur des Menschen. Das optimale Management dieser Verletzung erfordert umfassende Kenntnisse und Fähigkeiten hinsichtlich geschlossener und offener Repositionsmanöver, Gipstechnik und verschiedener Osteosynthesetechniken. Typische, aber auch seltene Begleitverletzungen müssen erkannt und in das Behandlungsregime einbezogen werden.

Abstract

The fracture of the distal radius is the most common human fracture. The optimal management of this injury requires extensive knowledge and skills regarding closed and open reposition maneuvers, plastering and various surgical osteosynthesis techniques. Typical as well as rare accompanying injuries must be recognized and included in the treatment regimen.

Kernaussagen

  • Wenn man sich für eine notfallmäßige Anlage eines das Handgelenk überbrückenden Fixateur externe entscheidet, dann sollte das CT erst postoperativ erfolgen, um die weitere Versorgung optimal planen zu können und den Patienten nicht unnötig ionisierender Strahlung auszusetzen.

  • Bei Trümmerfrakturen mit starker Verkürzung ist eine Plattenosteosynthese ohne zusätzlichen Fixateur externe manchmal nicht ausreichend.

  • Flexionsfrakturen des distalen Radius können meist nicht konservativ im Gips gehalten werden und erfordern regelhaft eine zeitnahe palmare Plattenosteosynthese.

  • Intraoperativ sollte bei palmarer Plattenosteosynthese standardmäßig zum Abschluss der Operation auch eine Skyline View angefertigt werden. So kann man distal zu lange Schrauben sicher erkennen und ggf. noch austauschen. Ansonsten drohen Strecksehnenrupturen.

  • Dorsale Platten sollten so früh wie möglich wieder entfernt werden, um Strecksehnenrupturen zu vermeiden.

Schlüsselwörter

Traumatologie - Unfallchirurgie - obere Extremität - Osteosynthese

Key words

traumatology - trauma surgery - upper limb - osteosynthesis


Publication History

Article published online:
14 July 2020

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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