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Insuffizienzfrakturen des Beckenrings

Insufficiency fractures of the pelvic ring

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Zusammenfassung

Die demografischen Veränderungen unserer Gesellschaft führen zwangsläufig zu einer Zunahme der spezifischen Erkrankungen und Verletzungen der älteren Generation. So steigt auch der prozentuale Anteil an osteoporotischen und Ermüdungsfrakturen insgesamt und damit die absolute Anzahl der Insuffizienzfrakturen des Beckenrings. Beim jungen Menschen ist eine Beckenringfraktur meist Folge eines Hochrasanztraumas. Im Alter kommt es oft bereits bei Niedrigenergietraumen oder gar ohne Trauma zu dieser Verletzung, welche dann als Insuffizienzfraktur zu werten ist, deren Problematik in der konventionellen Klassifikation nicht ausreichend abgebildet wird. Oft muss die konventionelle radiologische Diagnostik durch schnittbildgebende Verfahren ergänzt werden. Die Therapieformen müssen stärker als bei den klassischen Frakturen an den Allgemeinzustand und die Lebensumstände des Patienten angepasst werden und die deutlich verminderte Haltekraft der Osteosynthesen im veränderten Knochen berücksichtigen.

Abstract

The demographic changes in society automatically lead to an increase in specific diseases and injuries in the older generation. Therefore, the proportion of osteoporotic and fatigue fractures increases in total and also the absolute number of insufficiency fractures of the pelvic ring. In younger people pelvic ring fractures are mostly due high speed trauma. In the elderly this often occurs by low energy trauma or even with no trauma which is then designated as insufficiency fracture. The problematic of such fractures is insufficiently covered in the conventional classification. Conventional radiological diagnostics must often be supplemented by slice imaging procedures. The therapy forms must be more closely adapted to the general condition and physical health of the patient than by classical fractures and the substantially reduced sustainability of osteosynthesis in altered bones must be taken into consideration.

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Abbreviations

AO:

Arbeitsgemeinschaft für Osteosynthesefragen

CT:

Computertomographie

ISG:

Iliosakralgelenk

L:

Lumbal

LWK:

Lendenwirbelkörper

LWS:

Lendenwirbelsäule

MPR:

Multiplanare Rekonstruktion

MRT:

Magnetresonanztomographie

OTA:

„Orthopedic Trauma Association“

PET:

Positronenemissionstomographie

PMMA:

Polymethylmethacrylat

PTH:

Parathormon

S:

Sakral

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  1. Traumatologie, Abteilung für Unfall- und Wiederherstellungschirurgie, Eberhard–Karls–Universität, BG-Unfallklinik Tübingen, Schnarrenbergstraße 95, 72076, Tübingen, Deutschland

    F.M. Stuby, A. Schäffler, T. Haas, B. König, U. Stöckle & T. Freude

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  1. F.M. Stuby
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  2. A. Schäffler
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  3. T. Haas
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  4. B. König
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  5. U. Stöckle
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  6. T. Freude
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Correspondence to F.M. Stuby.

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Stuby, F., Schäffler, A., Haas, T. et al. Insuffizienzfrakturen des Beckenrings. Unfallchirurg 116, 351–366 (2013). https://doi.org/10.1007/s00113-012-2349-y

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