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Z Orthop Unfall 2021; 159(03): 323-331
DOI: 10.1055/a-1079-6476
Miscellaneous/Sonstige

Frühkorrekturen nach fehlgeschlagener Osteosynthese bei Sprunggelenkfrakturen

Article in several languages: English | deutsch
Christine Marx
UniversitätsCentrum für Orthopädie und Unfallchirurgie (OUC), Universitätsklinikum Carl Gustav Carus, Dresden
,
Klaus Dieter Schaser
UniversitätsCentrum für Orthopädie und Unfallchirurgie (OUC), Universitätsklinikum Carl Gustav Carus, Dresden
,
Stefan Rammelt
UniversitätsCentrum für Orthopädie und Unfallchirurgie (OUC), Universitätsklinikum Carl Gustav Carus, Dresden
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Zusammenfassung

Bereits geringe residuale Fehlstellungen nach Osteosynthese von Sprunggelenkfrakturen gehen mit einer verschlechterten Prognose einher. Häufige Ursachen für nicht anatomische Repositionen sind Fibulaverkürzungen bei Trümmerfrakturen oder schlechter Knochenqualität, Fehlstellungen und Malrotationen der distalen Fibula in der Tibiainzisur bei instabilen Syndesmosenverletzungen sowie nicht adressierte knöcherne Ausrisse der vorderen oder hinteren Syndesmose. Nach operativer Versorgung von Frakturen mit notwendiger Syndesmosenstabilisierung, komplexer Frakturmorphologie sowie bei jedem Verdacht auf eine ungenügende Reposition im postoperativen Röntgenbild sollte eine CT-Kontrolle unter Einbeziehung der unverletzten Seite erfolgen. Die Korrektur relevanter Fehlstellungen sollte so früh wie möglich erfolgen, um die Rehabilitation zu beschleunigen und Dauerschäden durch die Druckumverteilung bzw. Instabilität in einem lasttragenden Gelenk zu vermeiden.

Schlüsselwörter

Malleolarfraktur - Fehlstellung - Tubercule de Chaput - Tibiavorderkante - Tibiahinterkante


Publication History

Article published online:
10 February 2020

© 2021. Thieme. All rights reserved.

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