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Der Unfallchirurg

, Volume 122, Issue 1, pp 6–16 | Cite as

Knöcherne Knieverletzungen im Kindes- und Jugendalter

  • J. Bauer
  • I. Orendi
  • H. N. Ladenhauf
  • T. NeubauerEmail author
Leitthema

Zusammenfassung

Aufgrund der zunehmenden sportlichen Aktivität von Kindern und Jugendlichen steigt in den letzten Jahren die Zahl der sonst seltenen knöchernen Verletzungen rund um das kindliche Knie. Auch wenn die Therapie dieser Frakturen in manchen Fällen der im Erwachsenenalter ähnelt, erfordern die Diagnostik und Therapie im Kindes- und Jugendalter ein hohes Maß an Erfahrung, um mögliche Folgeschäden zu vermeiden bzw. frühzeitig zu erkennen. Die sorgfältige Diagnosestellung mithilfe klinischer und bildgebender Untersuchungen sowie genaues Abwägen der Behandlung sind zur Minimierung von Beinlängendifferenzen oder Achsenfehlstellungen des Beins essenziell. Sowohl am Femur als auch der Tibia wird je nach Frakturtyp zwischen konservativer und operativer Therapie entschieden. Ausschlaggebend ist maßgeblich der Dislokationsgrad der Fraktur. In der operativen Therapie sind die achsengerechte Reposition und anschließende (belastungs)stabile Versorgung besonders entscheidend. Avulsionstraumen, knöcherne Ausrisse der Eminentia intercondylaris und Verletzungen der Patella werden ebenfalls je nach Dislokationsgrad konservativ mit Ruhigstellung oder operativ mithilfe verschiedener Fixationstechniken versorgt.

Schlüsselwörter

Knochenfrakturen Sehnenverletzungen Epiphysenfuge Wachstumsstörungen Operative Versorgung 

Bony knee injuries in childhood and adolescence

Abstract

While fractures around the knee are known to be rare, physicians have encountered a rise in the frequency due to the increased participation of children and adolescents in high-impact sports at a younger age. Even if the treatment of fractures in some cases resembles that in adults, the diagnostics and treatment in childhood and adolescence require a hígh level of experience in order avoid possible sequelae and to enable early recognition. Thorough diagnostics using clinical and imaging investigations as well as a precise weighing up of the treatment are essential to minimize differences in leg length and axial malpositioning of the leg. A decision between conservative and operative treatment is made for both the femur and tibia depending on the type of fracture. Decisive is the degree of dislocation of the fracture. In operative treatment, the axis conform reduction and subsequent stress stable treatment are particularly decisive. Avulsion trauma, bony avulsions of the intercondylar eminence and patellar injuries are also treated conservatively with immobilization or surgically with the aid of various fixation techniques, depending on the degree of dislocation.

Keywords

Bone fractures Tendon injuries Epiphyseal plate Growth disturbances Operative treatment 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

J. Bauer, I. Orendi, H.N. Ladenhauf und T. Neubauer geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • J. Bauer
    • 1
  • I. Orendi
    • 1
  • H. N. Ladenhauf
    • 1
  • T. Neubauer
    • 2
    Email author
  1. 1.Universitätsklinik für Kinder und JugendchirurgieParacelsus Medizinische Privatuniversität SalzburgSalzburgÖsterreich
  2. 2.Unfallchirurgische AbteilungLandeskrankenhaus HornHornÖsterreich

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