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Rheumaoperationen im Wandel – „Fuß“

Rheumatism operations in a state of flux—“Foot”

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Zusammenfassung

Durch den Einsatz neuer Medikamente und die Entwicklung schonender Operationsmethoden hat sich die operative Versorgung des Rheumafußes deutlich gewandelt. Standen früher einige wenige gelenkresezierende Verfahren zur Disposition, sind heute die gelenkerhaltenden Methoden das Mittel der Wahl. Dennoch können übliche chirurgische Eingriffe, wie sie beim Nicht-Rheumatiker zum Einsatz kommen, nicht unreflektiert angewendet werden. Neben der verwendeten Basistherapie spielen Komorbiditäten, der Mobilitätsgrad der Patienten und die schuhtechnische und Hilfsmittelversorgung eine wesentliche Rolle. Durch den Rückgang der Inzidenz des klassischen Rheumafußes ist es für die behandelnden Ärzte bzw. Physio- und Ergotherapeuten umso wichtiger geworden, die Entwicklung eines solchen frühzeitig zu erkennen und die entsprechende Behandlung einzuleiten.

Abstract

Surgical management of rheumatic feet has dramatically changed over the last decades influenced by the development of new pharmacological drugs and tissue-preserving surgical procedures. It has switched from joint resection to joint-sparing procedures as the method of choice. Nevertheless, the surgical interventions commonly used for non-rheumatic patients cannot be applied to rheumatic patients without reflection: in addition to the basic treatment, comorbidities, degree of mobilization of the patient, orthopedic shoe engineering and orthotic treatment play a major role. Due to the decreasing incidence of the classical rheumatic foot, it has become even more important for physicians, physiotherapists and ergotherapists to recognize the development of such a disease as early as possible and immediately start the appropriate treatment.

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Authors and Affiliations

  1. Orthopädische Klinik für die Universität Regensburg, Asklepios Klinikum Bad Abbach, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Deutschland

    C. Baier, T. Schwarz, J. Schaumburger,  F. Leiß, J. Grifka & G. Maderbacher

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  1. C. Baier
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  2. T. Schwarz
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  3. J. Schaumburger
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  4. F. Leiß
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  5. J. Grifka
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  6. G. Maderbacher
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Correspondence to C. Baier.

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Interessenkonflikt

C. Baier, T. Schwarz, J. Schaumburger, F. Leiß, J. Grifka und G. Maderbacher geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patienten zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern eine schriftliche Einwilligung vor.

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J. Grifka, Bad Abbach

G. Maderbacher, Bad Abbach

C. Baier, Bad Abbach

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Baier, C., Schwarz, T., Schaumburger, J. et al. Rheumaoperationen im Wandel – „Fuß“. Z Rheumatol 77, 874–881 (2018). https://doi.org/10.1007/s00393-018-0528-0

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