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Frakturen des proximalen Unterarms

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Orthopädie und Unfallchirurgie

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Zusammenfassung

Mit einer Häufigkeit von etwa 5 % aller Frakturen und 25–30 % aller Ellenbogenverletzungen nehmen die Radiuskopffrakturen einen großen Anteil ein. MR-morphologische und biomechanische Untersuchungen haben gezeigt, dass Radiuskopffrakturen nicht selten mit Kapsel-Band-Verletzungen vergesellschaftet sind. Je weiter die Fraktur nach proximal extraartikulär in den Radiushals hineinreicht, desto relevanter wird die Stabilisierung nach den Prinzipien der Schaftfraktur. Es stehen die offene Reposition mit Plattenosteosynthese und die geschlossene Reposition mit intramedulärer Schienung mittels retrograder Nägel zur Verfügung. Die Wahl des Zugangs ist genau zu prüfen. Kombinationsverletzungen von Kopf- und Schaftfrakturen können zuweilen auch 2 Zugänge erfordern und müssen den Verlauf des motorischen R. profundus des N. radialis sowie den distalen Bizepssehnenansatz berücksichtigen. Die proximale Radiusfraktur ist somit im Hinblick auf ligamentäre Begleitverletzungen, komplexer Gelenkmechanik, Operationsindikation und Technik anspruchsvoll. Sie fordert ein fundiertes anatomisches Verständnis, eine detaillierte präoperative Planung und ausführliche Patientenaufklärung.

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Authors and Affiliations

  1. Universitätsklinik Würzburg, Klinik und Poliklinik für Unfall-, Hand-, Plastische- und Wiederherstellungschirurgie, Würzburg, Deutschland

    Rainer H. Meffert

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  1. Rainer H. Meffert
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Correspondence to Rainer H. Meffert .

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Editors and Affiliations

  1. Klinik für Orthopädie, Klinikum Osnabrück GmbH Klinik für Orthopädie, Osnabrück, Niedersachsen, Deutschland

    Martin Engelhardt

  2. Unfallchirurgie, Universitätsklinikum Münster Unfallchirurgie, Münster, Nordrhein-Westfalen, Deutschland

    Michael Raschke

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  1. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, UKM, Münster, Deutschland

    Jan Christoph Katthagen

  2. Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, UKM, Münster, Deutschland

    Benedikt Schliemann

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Meffert, R.H. (2020). Frakturen des proximalen Unterarms. In: Engelhardt, M., Raschke, M. (eds) Orthopädie und Unfallchirurgie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54673-0_72-1

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