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Arthritis und Rheuma 2015; 35(02): 97-99
DOI: 10.1055/s-0037-1618360
DOI: 10.1055/s-0037-1618360
Endoprothetik kleinerer Gelenke
Fehlgeschlagene OSG-Arthrodesen
Failed ankle arthrodesisWeitere Informationen
Publikationsverlauf
Publikationsdatum:
27. Dezember 2017 (online)
Zusammenfassung
Pseudarthrosen nach Arthrodesen des oberen Sprunggelenkes stellen mit modernen internen komprimierenden Arthrodeseverfahren mit einer Rate bis zu 6 % eine relativ seltene Komplikation dar. Neben patienten -bedingten Faktoren, die die lokale Knochenqualität und Durchblutung beeinflussen, sind es nicht optimale Operationstechniken, die Pseudarthrosen verursachen. Die Diagnose erfolgt durch Röntgen und CT; Infektpseud -arthrosen sollten mit Laboruntersuchungen und ggf. Biopsie aus geschlossen werden. Bei den Rearthrodesen ist mit modernen Schraubenarthrodesen, speziellen Platten und Arthrodesenägeln eine Re-Fusionsrate von 75–85 % zu erzielen.
Summary
Non-union after ankle arthrodesis are serious but with moderne internal compressive operative techniques at a frequence up to 6 % relatively seldom. Patient related factors that decrease the local bone quality and blood supply and non-optimal operative techniques are the main reasons for these non-unions. The non-union can be detected in radiographies and be clarified with a computer -tomography. Infected non-unions should be excluded with laboratory diagnostics and bio psies respectively. For re-fusions moderne screw arthrodesis techniques, special plates and arthrodesis nails are helpful and refusion rates of 75 % to 85 % can be achieved.
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