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Femurschaft: Fehlstellungen, Pseudarthrosen und Infektionen

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Tscherne Unfallchirurgie

Zusammenfassung

Das Erkennen und Behandeln von Fehlstellungen ist fester Bestandteil der Unfall- und Wiederherstellungschirurgie. Die exakte Diagnostik und Berechnung des Ausmaßes von Fehlstellungen ist unerlässlich für die präoperative Planung und das spätere Operationsergebnis. Die Indikation zur Korrektur ist von verschiedenen Faktoren abhängig und muss im Vorfeld sorgfältig abgewogen und individuell entschieden werden. Da es sich hierbei fast ausschließlich um elektive Eingriffe handelt, müssen Risiken und Nutzen sowie die operative Umsetzbarkeit kritisch abgewogen werden. Eine umfassende Aufklärung über die meist langwierige postoperative Behandlung und die genaue Beurteilung der Compliance des Patienten sind ausschlaggebend für den Erfolg dieser Therapie.

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Literatur

  • Braten M, Terjesen T, Rossvoll I (1993) Torsional deformity after intramedullary nailing of femoral shaft fractures. Measurement of anteversion angles in 110 patients. J Bone Joint Surg Br 75:799–803

    PubMed  CAS  Google Scholar 

  • Browner BD, Jupiter JB, Levine AM (1998) Skeletal Trauma. Saunders, Philadelphia, S 2017–2031

    Google Scholar 

  • Brumback RJ, Virkus WW (2000) Intramedullary nailing of the femur: reamed versus nonreamed. J Am Acad Orthop Surg 8:83–90

    PubMed  CAS  Google Scholar 

  • Canadian Orthopaedic Trauma Society (2003) Nonunion following intramedullary nailing of the femur with and without reaming. Results of a multicenter randomized clinical trial. J Bone Joint Surg Am 85-A(11):2093–2096

    Google Scholar 

  • Carey RP, de Campo JF, Menelaus MB (1987) Measurement of leg length by computerised tomographic scanography: brief report. J Bone Joint Surg Br 69:846–847

    PubMed  CAS  Google Scholar 

  • Cierny G 3rd, Mader JT, Penninck JJ (2003) A clinical staging system for adult osteomyelitis. Clin Orthop Relat Res 414:7–24

    Google Scholar 

  • Dugdale TW, Degnan GG, Turen CH (1992) The use of computed tomographic scan to assess femoral malrotation after intramedullary nailing. A case report. Clin Orthop Relat Res 279:258–263

    PubMed  Google Scholar 

  • Ebraheim NA, Sabry FF, Elgafy H (2002) Intramedullary fibular allograft and nail for treatment of femoral shaft nonunion. Am J Orthop 31(5):270–272

    PubMed  Google Scholar 

  • Ekkernkamp A, Muhr G (1996) Infected pseudarthrosis. Unfallchirurg 99(12):913

    Article  PubMed  CAS  Google Scholar 

  • Grutzner P, Hochstein P, Simon R, Wentzensen A (1999) Determination of torsion angle after shaft fractures of the lower extremity – clinical relevance and measurement techniques. Chirurg 70:276–284

    Article  PubMed  CAS  Google Scholar 

  • Hankemeier S, Bastian L, Gosling T, Krettek C (2004) Principles of callus distraction. Unfallchirurg 107:945–958; quiz 959

    Article  PubMed  CAS  Google Scholar 

  • Hesser J, Krivonos O, Manner R, Keppler P, Gebhard F, Kinzl L (2002) Operation planning of correction osteotomies in 3D. Biomed Tech (Berl) 47(Suppl 1 Pt 1):90–92

    Article  Google Scholar 

  • Hoaglund FT, Low WD (1980) Anatomy of the femoral neck and head, with comparative data from Caucasians and Hong Kong Chinese. Clin Orthop Relat Res 152:10–16

    PubMed  Google Scholar 

  • Hsu RW, Himeno S, Coventry MB, Chao EY (1990) Normal axial alignment of the lower extremity and load-bearing distribution at the knee. Clin Orthop Relat Res 255:215–227

    PubMed  Google Scholar 

  • Johnson EE, Urist MR (1998) One-stage lengthening of femoral nonunion augmented with human bone morphogenetic protein. Clin Orthop Relat Res 347:105–116

    PubMed  Google Scholar 

  • Kasperczyk WJ, Mahlke L, Tscherne H (1996) Diaphyseal pseudarthroses. Epidemiology and outcome. Orthopäde 25(5):416–428

    Article  PubMed  CAS  Google Scholar 

  • Kempf I, Grosse A, Abalo C (1986a) Locked intramedullary nailing. Its application to femoral and tibial axial, rotational, lengthening, and shortening osteotomies. Clin Orthop Relat Res 212:165–173

    Google Scholar 

  • Kempf I, Grosse A, Rigaut P (1986b) The treatment of noninfected pseudarthrosis of the femur and tibia with locked intramedullary nailing. Clin Orthop Relat Res 212:142–154

    Google Scholar 

  • Keppler P, Strecker W, Kinzl L (1998) Analysis of leg geometry – standard techniques and normal values. Chirurg 69:1141–1152

    Article  PubMed  CAS  Google Scholar 

  • Keppler P, Strecker W, Kinzl L (1999) CT determination of leg length and torsion in children and adolescents. Unfallchirurg 102:936–941

    PubMed  CAS  Google Scholar 

  • Keppler P, Suger G, Kinzl L, Strecker W (2002) Osteotomies in malalignments of the lower extremities. Chirurg 73:982–989

    Article  PubMed  CAS  Google Scholar 

  • Klemm KW (1986) Treatment of infected pseudarthrosis of the femur and tibia with an interlocking nail. Clin Orthop Relat Res 212:174–181

    PubMed  Google Scholar 

  • Knopp W, Muhr G, Rehn J (1989) „Prognostic“ analysis of late results of trochanteric femoral osteotomy following post-traumatic malalignment. Unfallchirurg 92:577–583

    PubMed  CAS  Google Scholar 

  • Lang S (1996) Osteomyelitis. A pathomorphologic overview. Radiologe 36(10):781–785

    Article  PubMed  CAS  Google Scholar 

  • Lucke M, Schmidmaier G, Sadoni S, Wildemann B, Schiller R, Haas NP, Raschke M (2003) Gentamicin coating of metallic implants reduces implant-related osteomyelitis in rats. Bone 32(5):521–531

    Article  PubMed  CAS  Google Scholar 

  • Mayr E, Wagner S, Ecker M, Ruter A (1999) Ultrasound therapy for nonunions. Three case reports. Unfallchirurg 102(3):191–196

    Article  PubMed  CAS  Google Scholar 

  • Murphy SB, Simon SR, Kijewski PK, Wilkinson RH, Griscom NT (1987) Femoral anteversion. J Bone Joint Surg Am 1169–1176

    Google Scholar 

  • Oedekoven G, Jansen D, Raschke M, Claudi BF (1996) The monorail system–bone segment transport over unreamed interlocking nails. Chirurg 67(11):1069–1079

    Article  PubMed  CAS  Google Scholar 

  • Paley D (2002) Principles of deformity correction. Springer, Berlin

    Google Scholar 

  • Paley D, Pfeil J (2000) Principles of deformity correction around the knee. Orthopäde 29:18–38

    PubMed  CAS  Google Scholar 

  • Paley D, Tetsworth K (1992) Mechanical axis deviation of the lower limbs. Preoperative planning of uniapical angular deformities of the tibia or femur. Clin Orthop Relat Res 280:48–64

    PubMed  Google Scholar 

  • Paley D, Herzenberg JE, Paremain G, Bhave A (1997) Femoral lengthening over an intramedullary nail. A matched-case comparison with Ilizarov femoral lengthening. J Bone Joint Surg Am 79(10):1464–1480

    PubMed  CAS  Google Scholar 

  • Pfeil J, Grill F, Graf R (1996) Extremitätenverlängerung, Deformitätenkorrektur, Pseudarthrosenbehandlung. Springer, Berlin

    Book  Google Scholar 

  • Pihlajamaki HK, Salminen ST, Bostman OM (2002) The treatment of nonunions following intramedullary nailing of femoral shaft fractures. J Orthop Trauma 16(6):394–402

    Article  PubMed  Google Scholar 

  • Raschke M, Ficke J, Freisleben C, Jansen D, Oedekoven G (1993a) Posttraumatic segmental and soft tissue defects of the tibia treated with the Ilizarov method. Injury 24(Suppl 2):S45–S53

    Article  Google Scholar 

  • Raschke M, Oedekoven G, Ficke J, Claudi BF (1993b) The monorail method for segment bone transport. Injury 24(Suppl 2):S54–S61

    Article  Google Scholar 

  • Raschke MJ, Bail H, Windhagen HJ, Kolbeck SF, Weiler A, Raun K, Kappelgard A, Skiaerbaek C, Haas NP (1999) Recombinant growth hormone accelerates bone regenerate consolidation in distraction osteogenesis. Bone 24(2):81–88

    Article  PubMed  CAS  Google Scholar 

  • Raschke MJ, Stosch-Wiechert K, Weiler A, Khodadadyan C, Haas NP (2000) Distraction of hypertrophic callus in the treatment of segmental bone loss in the femur. A case report. J Bone Joint Surg Am 82(1):101–104

    PubMed  CAS  Google Scholar 

  • Raschke M, Steenlage ES, Stange R, Schmidmaier G (2002) External fixation, intramedullarx nailing and bone transport: indications and limitations. Techn Orthop 17:197–206

    Article  Google Scholar 

  • Rompe JD, Eysel P, Hopf C, Vogel J, Kullmer K (1997) Extracorporeal shockwave treatment of delayed bone healing. A critical assessment. Unfallchirurg 100(10):845–849

    Article  PubMed  CAS  Google Scholar 

  • Runkel M, Rommens PM (2000) Pseudoarthrosis. Unfallchirurg 103(1):51–63; quiz 63

    Article  PubMed  CAS  Google Scholar 

  • Schmidmaier G, Wildemann B, Bail H, Lucke M, Fuchs T, Stemberger A, Flyvbjerg A, Haas NP, Raschke M (2001) Local application of growth factors (insulin-like growth factor-1 and transforming growth factor-beta1) from a biodegradable poly(D,L-lactide) coating of osteosynthetic implants accelerates fracture healing in rats. Bone 28(4):341–350

    Article  PubMed  CAS  Google Scholar 

  • Schmidmaier G, Wildemann B, Gabelein T, Heeger J, Kandziora F, Haas NP, Raschke M (2003) Synergistic effect of IGF-I and TGF-beta1 on fracture healing in rats: single versus combined application of IGF-I and TGF-beta1. Acta Orthop Scand 74(5):604–610

    Article  PubMed  Google Scholar 

  • Schmidmaier G, Herrmann S, Green J, Weber T, Scharfenberger A, Haas NP, Wildemann B (2006) Quantitative assessment of growth factors in reaming aspirate, iliac crest, and platelet preparation. Bone 39(5):1156–1163

    Article  PubMed  CAS  Google Scholar 

  • Schweiberer L, Baumgart R, Deiler S (1999) The biological reaction in atrophic and hypertrophic pseudarthrosis of diaphysis of long bone. Causes and forms of appearance. Chirurg 70(11):1193–1201

    Article  PubMed  CAS  Google Scholar 

  • Shtarker H, Volpin G, Stolero J, Kaushansky A, Samchukov M (2002) Correction of combined angular and rotational deformities by the Ilizarov method. Clin Orthop Relat Res 402:184–195

    Article  PubMed  Google Scholar 

  • Strecker W, Suger G, Kinzl L (1996) Local complications of intramedullary nailing. Orthopäde 25(3):274–291

    PubMed  CAS  Google Scholar 

  • Strecker W, Becker U, Hehl G, Hoellen I, Kinzl L (1997a) Unilateral stepwise lengthening osteotomy of the femur. Unfallchirurg 100:124–132

    Article  CAS  Google Scholar 

  • Strecker W, Hoellen I, Keppler P, Suger G, Kinzl L (1997b) Correcting torsion after intramedullary nailing osteosynthesis of the lower extremity. Unfallchirurg 100:29–38

    Article  CAS  Google Scholar 

  • Strecker W, Keppler P, Gebhard F, Kinzl L (1997c) Length and torsion of the lower limb. J Bone Joint Surg Br 79:1019–1023

    Article  CAS  Google Scholar 

  • Suger G, Liener U, Schmelz A, Kinzl L (1998) Correction of post-traumatic diaphyseal malalignment of the lower extremity. Chirurg 69:1167–1177

    Article  PubMed  CAS  Google Scholar 

  • Tornetta P 3rd, Ritz G, Kantor A (1995) Femoral torsion after interlocked nailing of unstable femoral fractures. J Trauma 38:213–219

    Article  PubMed  Google Scholar 

  • Waidelich HA, Strecker W, Schneider E (1992) Computed tomographic torsion-angle and length measurement of the lower extremity. The methods, normal values and radiation load. Rofo 157:245–251

    Article  PubMed  CAS  Google Scholar 

  • Weber BG, Cech O (1973) Pseudarthrosen, Pathophysiologie, Biomechanik, Therapie, Ergebnisse. Hans Huber, Bern

    Google Scholar 

  • Wedge JH, Munkacsi I, Loback D (1989) Anteversion of the femur and idiopathic osteoarthrosis of the hip. J Bone Joint Surg Am 71:1040–1043

    PubMed  CAS  Google Scholar 

  • Weise K, Winter E (1996) Role of intramedullary nailing in pseudarthrosis and malalignment. Orthopade 25:247–258

    PubMed  CAS  Google Scholar 

  • Winquist RA (1986) Closed intramedullary osteotomies of the femur. Clin Orthop Relat Res 212:155–164

    PubMed  Google Scholar 

  • Wiss DA, Fleming CH, Matta JM, Clark D (1986) Comminuted and rotationally unstable fractures of the femur treated with an interlocking nail. Clin Orthop Relat Res 212:35–47

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum, Waldeyerstr. 1, 48149, Münster, Deutschland

    M. J. Raschke & R. Stange

Authors
  1. M. J. Raschke
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  2. R. Stange
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Correspondence to M. J. Raschke .

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Editors and Affiliations

  1. Charité Campus Virchow-Klinikum (CVK), Centrum für Muskuloskeletale Chirurgie, Universitätsmedizin Berlin, Augustenburgerplatz 1, Berlin, 13353, Berlin, Germany

    Norbert P. Haas

  2. Klinik für Unfallchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, Hannover, 30625, Germany

    Christian Krettek

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Raschke, M.J., Stange, R. (2012). Femurschaft: Fehlstellungen, Pseudarthrosen und Infektionen. In: Haas, N., Krettek, C. (eds) Tscherne Unfallchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68741-2_11

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  • DOI: https://doi.org/10.1007/978-3-540-68741-2_11

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  • Online ISBN: 978-3-540-68741-2

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