Die Bedeutung der Biomechanik bei der physiologischen Frakturheilung

Zusammenfassung

Um Frakturheilungszeiten zu minimieren und Patienten eine möglichst schnelle und weitestgehende Rehabilitation zu ermöglichen, ist ein Verständnis sowohl der biologischen Prozesse der Heilung als auch der mechanischen Bedingungen, unter denen diese Heilung vonstatten geht, nötig. Wissen um die mechanischen Bedingungen ist insbesondere deshalb von Bedeutung, da die biologischen Prozesse der Heilung und Regeneration von den durch Muskelund Gelenkkräfte definierten Rahmenbedingungen wesentlich beeinflusst werden. Durch die Wahl der Osteosynthese können die mechanischen Rahmenbedingungen an der Fraktur und dem physikalischen Stimulus, dem die zellulären Strukturen ausgesetzt sind, weiter moduliert werden. Unabhängig von der Methode der Fraktur-stabilisierung ist die sekundäre Knochenheilung immer einer komplexen interfragmentären Bewegung ausgesetzt. Dabei beeinflussen die auftretenden Fragmentbewegungen den Heilungsprozess in seiner Art und Schnelligkeit.

Summary

To minimize fracture healing times and to enable patients fast rehabilitation, an understanding of both the biological processes of healing and the mechanical conditions, under which this healing is taking place, is necessary. Knowledge of the mechanical conditions is of particular interest because the biological processes of healing and regeneration are affected by the environment defined by muscle and joint forces. The mechanical conditions at the fracture and the physical stimulus, which cellular structures are exposed to, can be further modulated by the choice of internal fixation. Regardless of the fracture stabilization, secondary bone healing underlies complex interfragmentary movements. Here, the interfragmentary movements influence the bone healing process itself and the regeneration speed.

Schlüsselwörter

Knochenheilung - enchondrale Ossifikation - Vaskularität - interfragmentäre Bewegung - Biomechanik

Keywords

Bone healing - endochondral ossification - vascularity - interfragmentary movement - biomechanics

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