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Z Orthop Unfall 2023; 161(06): 610-618
DOI: 10.1055/a-1766-7781
Übersicht

Belastungsvorgaben nach distaler Femurfraktur - eine aktuelle Literaturübersicht

Article in several languages: deutsch | English
Benedikt J. Braun
1   Klinik für Unfall- und Wiederherstellungschirurgie, BG Klinik Tübingen, Tübingen, Deutschland (Ringgold ID: RIN64374)
,
Kira Hofmann
1   Klinik für Unfall- und Wiederherstellungschirurgie, BG Klinik Tübingen, Tübingen, Deutschland (Ringgold ID: RIN64374)
,
Mika FR Rollmann
1   Klinik für Unfall- und Wiederherstellungschirurgie, BG Klinik Tübingen, Tübingen, Deutschland (Ringgold ID: RIN64374)
,
Maximilian M Menger
1   Klinik für Unfall- und Wiederherstellungschirurgie, BG Klinik Tübingen, Tübingen, Deutschland (Ringgold ID: RIN64374)
,
Marc-Daniel Ahrend
1   Klinik für Unfall- und Wiederherstellungschirurgie, BG Klinik Tübingen, Tübingen, Deutschland (Ringgold ID: RIN64374)
,
Christoph Ihle
1   Klinik für Unfall- und Wiederherstellungschirurgie, BG Klinik Tübingen, Tübingen, Deutschland (Ringgold ID: RIN64374)
,
Tina Histing
1   Klinik für Unfall- und Wiederherstellungschirurgie, BG Klinik Tübingen, Tübingen, Deutschland (Ringgold ID: RIN64374)
,
Steven C. Herath
1   Klinik für Unfall- und Wiederherstellungschirurgie, BG Klinik Tübingen, Tübingen, Deutschland (Ringgold ID: RIN64374)
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Zusammenfassung

Die Inzidenz der distalen Femurfraktur steigt gerade auch bei geriatrischen Patienten deutlich an. Grundsätzliches Ziel der Behandlung dieser Verletzung ist eine frühzeitige Mobilisation der Patienten zur Prävention immobilisationsassoziierter Begleiterkrankungen. Vor dem Hintergrund einer steigenden Anzahl an Therapieoptionen, wie der Doppelplattenosteosynthese, Nagel-Platte-Kombinationen sowie dem distalen Femurersatz, gewinnen Überlegungen zur möglichen Belastung nach der Versorgung einen neuen Stellenwert. Ziel dieser Arbeit war es daher, die bestehende Literatur der vergangenen 9 Jahre hinsichtlich Belastungsvorgaben und klinischer Ergebnisse der verschiedenen Therapieoptionen aufzuarbeiten und mit dem eigenen Vorgehen abzugleichen.

Schlüsselwörter

distale Femurfraktur - postoperative Belastungsvorgaben - Vollbelastung - Teilbelastung


Publication History

Received: 12 September 2021

Accepted after revision: 07 February 2022

Article published online:
21 March 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Literatur

  • 1 Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury 2006; 37: 691-697
    CrossrefPubMedSearch in Google Scholar
  • 2 Court-Brown CM, Biant L, Bugler KE. et al. Changing epidemiology of adult fractures in Scotland. Scott Med J 2014; 59: 30-34
    CrossrefPubMedSearch in Google Scholar
  • 3 Elsoe R, Ceccotti AA, Larsen P. Population-based epidemiology and incidence of distal femur fractures. Int Orthop 2018; 42: 191-196
    CrossrefPubMedSearch in Google Scholar
  • 4 Ferris H, Brent L, Coughlan T. Early mobilisation reduces the risk of in-hospital mortality following hip fracture. Eur Geriatr Med 2020; 11: 527-533
    CrossrefPubMedSearch in Google Scholar
  • 5 Hake ME, Davis ME, Perdue AM. et al. Modern implant options for the treatment of distal femur fractures. J Am Acad Orthop Surg 2019; 27: e867-e875
    CrossrefPubMedSearch in Google Scholar
  • 6 Fontenot PB, Diaz M, Stoops K. et al. Supplementation of lateral locked plating for distal femur fractures: a biomechanical study. J Orthop Trauma 2019; 33: 642-648
    CrossrefPubMedSearch in Google Scholar
  • 7 Braun BJ, Veith NT, Rollmann M. et al. Weight-bearing recommendations after operative fracture treatment—fact or fiction? Gait results with and feasibility of a dynamic, continuous pedobarography insole. Int Orthop 2017; 41: 1507-1512
    CrossrefPubMedSearch in Google Scholar
  • 8 Kammerlander C, Pfeufer D, Lisitano LA. et al. Inability of older adult patients with hip fracture to maintain postoperative weight-bearing restrictions. J Bone Joint Surg Am 2018; 100: 936-941
    CrossrefPubMedSearch in Google Scholar
  • 9 Pfeufer D, Zeller A, Mehaffey S. et al. Weight-bearing restrictions reduce postoperative mobility in elderly hip fracture patients. Arch Orthop Trauma Surg 2019; 139: 1253-1259
    CrossrefPubMedSearch in Google Scholar
  • 10 Unger EW, Histing T, Rollmann MF. et al. Development of a dynamic fall risk profile in elderly nursing home residents: A free field gait analysis based study. Arch Gerontol Geriatr 2021; 93: 104294
    CrossrefPubMedSearch in Google Scholar
  • 11 Keenan OJ, Ross LA, Magill M. et al. Immediate weight-bearing is safe following lateral locked plate fixation of periprosthetic distal femoral fractures. Knee Surg Relat Res 2021; 33: 19
    CrossrefPubMedSearch in Google Scholar
  • 12 Sidhu GAS, Singh H, Selhi H. et al. The Clinical and Radiological Evaluation of Far Cortex Locking Plate in Distal Femur Fractures. Cureus 2021; 13: e14289
    CrossrefPubMedSearch in Google Scholar
  • 13 Loosen A, Fritz Y, Dietrich M. Surgical treatment of distal femur fractures in geriatric patients. Geriatr Orthop Surg Rehabil 2019; 10: 2151459319860723
    CrossrefPubMedSearch in Google Scholar
  • 14 Consigliere P, Iliopoulos E, Ads T. et al. Early versus delayed weight bearing after surgical fixation of distal femur fractures: a non-randomized comparative study. Eur J Orthop Surg Traumatol 2019; 29: 1789-1794
    CrossrefPubMedSearch in Google Scholar
  • 15 Wang SH, Wu CC, Li WT. et al. Outcomes of distal femoral fractures treated with minimally invasive plate osteosynthesis versus open reduction internal fixation with combined locking plate and interfragmentary screws. Int J Surg 2019; 65: 107-112
    CrossrefPubMedSearch in Google Scholar
  • 16 Mitchell PM, Lee AK, Collinge CA. et al. Early Comparative Outcomes of Carbon Fiber-Reinforced Polymer Plate in the Fixation of Distal Femur Fractures. J Orthop Trauma 2018; 32: 386-390
    CrossrefPubMedSearch in Google Scholar
  • 17 Poole WEC, Wilson DGG, Guthrie HC. et al. ‘Modern’distal femoral locking plates allow safe, early weight-bearing with a high rate of union and low rate of failure: five-year experience from a United Kingdom major trauma centre. Bone Joint J 2017; 99: 951-957
    CrossrefPubMedSearch in Google Scholar
  • 18 Smith WR, Stoneback JW, Morgan SJ. et al. Is immediate weight bearing safe for periprosthetic distal femur fractures treated by locked plating? A feasibility study in 52 consecutive patients. Patient Saf Surg 2016; 10: 26
    CrossrefPubMedSearch in Google Scholar
  • 19 Smith JR, Halliday R, Aquilina AL. et al. Distal femoral fractures: the need to review the standard of care. Injury 2015; 46: 1084-1088
    CrossrefPubMedSearch in Google Scholar
  • 20 Khursheed O, Wani MM, Rashid S. et al. Results of treatment of distal extra: articular femur fractures with locking plates using minimally invasive approach—experience with 25 consecutive geriatric patients. Musculoskelet Surg 2015; 99: 139-147
    CrossrefPubMedSearch in Google Scholar
  • 21 Horneff 3rd JG, Scolaro JA, Jafari SM. et al. Intramedullary nailing versus locked plate for treating supracondylar periprosthetic femur fractures. Orthopedics 2013; 36: e561-e566
    CrossrefPubMedSearch in Google Scholar
  • 22 Lieder CM, Gaski GE, Virkus WW. et al. Is immediate weight-bearing safe after single implant fixation of elderly distal femur fractures?. J Orthop Trauma 2021; 35: 49-55
    CrossrefPubMedSearch in Google Scholar
  • 23 Zhao Z, Li Y, Ullah K. et al. The antegrade angle-stable locking intramedullary nail for type-C distal femoral fractures: a thirty four case experience. Int Orthop 2018; 42: 659-665
    CrossrefPubMedSearch in Google Scholar
  • 24 Biber R, Bail HJ. Retrograde Marknagelung bei periprothetischen Frakturen des distalen Femurs. Oper Orthop Traumatol 2014; 26: 438-454
    CrossrefPubMedSearch in Google Scholar
  • 25 Al Farii H, Cloutier J-P, AlQahtani S. et al. Endosteal substitution with medial plate in the treatment of acute distal femur fracture (AO/OTA type A): surgical technique and case-series. Eur J Orthop Surg Traumatol 2022; 32: 211-217
    CrossrefPubMedSearch in Google Scholar
  • 26 Park KH, Oh CW, Park KC. et al. Excellent outcomes after double-locked plating in very low periprosthetic distal femoral fractures. Arch Orthop Trauma Surg 2021; 141: 207-214
    CrossrefPubMedSearch in Google Scholar
  • 27 Liporace FA, Yoon RS. Nail plate combination technique for native and periprosthetic distal femur fractures. J Orthop Trauma 2019; 33: e64-e68
    CrossrefPubMedSearch in Google Scholar
  • 28 Hussain MS, Dailey SK, Avilucea FR. Stable fixation and immediate weight-bearing after combined retrograde intramedullary nailing and open reduction internal fixation of noncomminuted distal interprosthetic femur fractures. J Orthop Trauma 2018; 32: e237-e240
    CrossrefPubMedSearch in Google Scholar
  • 29 Bettin CC, Weinlein JC, Toy PC. et al. Distal femoral replacement for acute distal femoral fractures in elderly patients. J Orthop Trauma 2016; 30: 503-509
    CrossrefPubMedSearch in Google Scholar
  • 30 Rao B, Kamal T, Vafe J. et al. Distal femoral replacement for selective periprosthetic fractures above a total knee arthroplasty. Eur J Trauma Emerg Surg 2014; 40: 191-199
    CrossrefPubMedSearch in Google Scholar
  • 31 Fakler JK, Hepp P, Marquaß B. et al. Is distal femoral replacement an adequate therapeutic option after complex fractures of the distal femur?. Z Orthop Unfall 2013; 151: 173-179
    Thieme ConnectPubMedSearch in Google Scholar
  • 32 Zhang Y, Zhao X, Tang Y. et al. Application of Ni-Ti Alloy connector for the treatment of comminuted coronal plane supracondylar-condylar femoral fractures: a retrospective review of 21 patients. BMC Musculoskelet Disord 2013; 14: 355
    CrossrefPubMedSearch in Google Scholar
  • 33 Bel JC, Court C, Cogan A. et al. Unicondylar fractures of the distal femur. Orthop Traumatol Surg Res 2014; 100: 873-877
    CrossrefPubMedSearch in Google Scholar
  • 34 Kubiak EN, Beebe MJ, North K. et al. Early weight bearing after lower extremity fractures in adults. JAAOS-J Am Acad Orthop Surg 2013; 21: 727-738
    CrossrefPubMedSearch in Google Scholar
  • 35 Wähnert D, Hoffmeier K, Fröber R. et al. Distal femur fractures of the elderly – different treatment options in a biomechanical comparison. Injury 2011; 42: 655-659
    CrossrefPubMedSearch in Google Scholar