Management komplexer distaler Radiusfrakturen

 

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Zusammenfassung

Komplexe distale Speichenbrüche können einhergehen mit ausgedehnten Gelenkzertrümmerungen, schweren Weichteilverletzungen, ausgedehnten meta-/diaphysären Knochendefekten, assoziierten ossären oder ligamentären karpalen Verletzungen oder deren Kombination. Für das Management dieser schweren Verletzungen empfehlen wir ein standardisiertes, dreistufiges Versorgungskonzept. In der Notfallsituation wird ein handgelenksüberbrückender Fixateur externe angelegt. Dies erlaubt die Behandlung der Weichteile und die Durchführung weiterer bildgebender Diagnostik. Der letzte Schritt besteht in der definitiven, adaptierten operativen Therapie entsprechend der Analyse der spezifischen Verletzung.

Abstract

Complex injuries of the distal radius can be associated with articular comminution, severe soft tissue injury, large metaphyseal and/or diaphyseal bone defects, carpal ligament tears or its combinations. We recommend a standardized three step approach for the management of these severe injuries: external fixation as an emergency procedure; treatment of soft tissue damage and further diagnostics as needed; definitive adapted operative therapy after thorough analysis of the specific injury.

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Daniel A. Rikli

Leitender Arzt Chirurgie A

Kantonsspital

6000 Luzern

Schweiz

Email: daniel.rikli@ksl.ch