Advertisement

Versorgung der Sprunggelenkfraktur: operative Technik

Standards, Tipps und Fallstricke

Treatment of ankle fractures: operative techniques

Standards, tips and pitfalls

  • 306 Accesses

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5
Abb. 6
Abb. 7
Abb. 8
Abb. 9
Abb. 10

Literatur

  1. 1.

    Rammelt S, Grass R, Zwipp H (2008) Sprunggelenkfrakturen. Unfallchirurg 111:412–438

  2. 2.

    Heim D, Niederhauser K (2007) Die Drittelrohrhakenplatte. Oper Orthop Traumatol 3:305–309

  3. 3.

    Rammelt S, Zwipp H, Mittlmeier T (2013) Therapie der Sprunggelenks-Luxationsfrakturen vom Pronationstyp. Oper Orthop Traumatol 25:273–293

  4. 4.

    Heim U, Pfeiffer KM (1988) Periphere Osteosynthesen. Springer, Berlin, Heidelberg, New York

  5. 5.

    Schaffer JJ, Manoli A 2nd (1987) The antiglide plate for distal fibular fixation. A biomechanical comparison with fixation with a lateral plate. J Bone Joint Surg Am 69:596–604

  6. 6.

    Weber M, Krause F (2005) Peroneal tendon lesions caused by antiglide plates used for fixation of lateral malleolar fractures: the effect of plate and screw position. Foot Ankle Int 26:281–285

  7. 7.

    Rammelt S, Manke E (2018) Syndesmosenverletzungen. Unfallchirurg 121:693–703

  8. 8.

    Buckley R, Kwek E, Duffy P, Korley R, Puloski S, Buckley A, Martin R, Rydberg Moller E, Schneider P (2018) Single-screw fixation compared with double screw fixation for treatment of medial malleolar fractures: a prospective randomized trial. J Orthop Trauma 32(11):548–553

  9. 9.

    McConnell T, Tornetta P (2001) Marginal plafond impaction in association with supination-adduction ankle fractures: a report of eight cases. J Orthop Trauma 15(6):447–449

  10. 10.

    Rammelt S, Heim D, Hofbauer LC, Grass R, Zwipp H (2011) Probleme und Kontroversen in der Behandlung von Sprunggelenkfrakturen. Unfallchirurg 114:847–860

  11. 11.

    Stromsoe K, Hoqevold HE, Skjeldal S, Alho A (1995) The repair of a ruptured deltoid ligament is not necessary in ankle fractures. J Bone Joint Surg Br 77:920–921

  12. 12.

    Sun X, Li T, Sun Z, Li Y, Yang M, Li S, Lv Z, Jiang X, Yong W, Wu X, Wang M (2018) Does routinely repairing deltoid ligament injuries in type B ankle joint fractures influence long term outcomes? Injury 49(12):2312–2317

  13. 13.

    Bartoníček J, Rammelt S, Tuček M (2017) Posterior malleolar fractures of the ankle. Changing concepts and recent developments. Foot Ankle Clin 22:125–145

  14. 14.

    Miller AN, Carroll EA, Parker RJ, Helfet DL, Lorich DG (2010) Posterior malleolar stabilization of syndesmotic injuries is equivalent to screw fixation. Clin Orthop Relat Res 468:1129–1135

  15. 15.

    Baumbach SF, Herterich V, Damblemont A, Hieber F, Böcker W, Polzer H (2019) Open reduction and internal fixation of the posterior malleolar fragment frequently restores syndesmotic stability. Injury 50:564–570

  16. 16.

    Heim D, Niederhauser K, Simbray N (2010) The Volkmann dogma: a retrospective, long-term, single-center study. Eur J Trauma Emerg Surg 36:515–515

  17. 17.

    Ferries JS, DeCoster TA, Firoozbakhsh KK, Garcia JF, Miller RA (1994) Plain radiographic interpretation in trimalleolar ankle fractures poorly assesses posterior fragment size. J Orthop Trauma 8(4):328–331

  18. 18.

    Hoekstra H, Rosseels W, Rammelt S, Nijs S (2017) Direct fixation of fractures of the posterior pilon via a posteromedial approach. Injury 48:1269–1274

  19. 19.

    Rammelt S (2019) Malleolar fractures. In: Rammelt S, Swords M, Dhillon M, Sands A (Hrsg) AO manual of fracture management. Foot & ankle. Thieme, Stuttgart, New York, S 115–130

  20. 20.

    Stoffel K, Wysocki D, Baddour E, Nicholls R, Yates P (2009) Comparison of two intraoperative assessment methods for injuries to the ankle syndesmosis. A cadaveric study. J Bone Joint Surg Am 91(11):2646–2652

  21. 21.

    Kamin K, Notov D, Al-Sadi O, Kleber C, Rammelt S (2020) Standards, Tipps und Fallstricke in der Versorgung der Sprunggelenkfraktur. Unfallchirurg. (in press)

  22. 22.

    Stark E, Tornetta P, Creevy WR (2007) Syndesmotic instability in Weber B ankle fractures: a clinical evaluation. J Orthop Trauma 21(9):643–646

  23. 23.

    Pelton K, Thordarson DB, Barnwell J (2010) Open versus closed treatment of the fibula in Maisonneuve injuries. Foot Ankle Int 31(7):604–608

  24. 24.

    Höcker K, Pachucki A (1989) Die Incisura fibularis tibiae. Die Stellung der Fibula in der distalen Syndesmose am Querschnitt. Unfallchirurg 92:401–406

  25. 25.

    Rammelt S, Zwipp H, Grass R (2008) Injuries to the distal tibiofibular syndesmosis. An evidence-based approach to acute and chronic lesions. Foot Ankle Clin 13:611–633

  26. 26.

    Helfet DL, Lorich DG (2006) Malreduction of the tibiofibular syndesmosis in ankle fractures. Foot Ankle Int 27(10):788–792

  27. 27.

    Vasarhelyi A, Lubitz J, Gierer P, Gradl G, Rosler K, Hopfenmuller W, Klaue K, Mittlmeier TW (2006) Detection of fibular torsional deformities after surgery for ankle fractures with a novel CT method. Foot Ankle Int 27:1115–1121

  28. 28.

    Thordarson DB, Motamed S, Hedman T, Ebramzadeh E, Bakshian S (1997) The effect of fibular malreduction on contact pressures in an ankle fracture malunion model. J Bone Joint Surg Am 79:1809–1815

  29. 29.

    Heineck J, Serra A, Haupt C, Rammelt S (2009) Accuracy of corrective osteotomies in fibular malunion: a cadaver model. Foot Ankle Int 30(8):773–777

  30. 30.

    Andersen MR, Frihagen F, Hellund JC, Madsen JE, Figved W (2018) Randomized trial comparing suture button with single syndesmotic screw for syndesmosis injury. J Bone Joint Surg Am 100(1):2–12

  31. 31.

    Laflamme M, Belzile EL, Bédard L, van den Bekerom MP, Glazebrook M, Pelet S (2015) A prospective randomized multicenter trial comparing clinical outcomes of patients treated surgically with a static or dynamic implant for acute ankle syndesmosis rupture. J Orthop Trauma 29(5):216–223

  32. 32.

    Honeycutt MW, Riehl JT (2019) Effect of a dynamic fixation construct on syndesmosis reduction: a cadaveric study. J Orthop Trauma 33(9):460–446

  33. 33.

    DeGroot H, Al-Omari AA, El Ghazaly SA (2011) Outcomes of suture button repair of the distal tibiofibular syndesmosis. Foot Ankle Int 32:250–256

  34. 34.

    Dingemans SA, Rammelt S, White TO, Goslings JC, Schepers T (2016) Should syndesmotic screws be removed after surgical fixation of unstable ankle fractures? A systematic review. Bone Joint J 98-B:1497–1504

  35. 35.

    Manjoo A, Sanders DW, Tieszer C et al (2010) Functional and radiographic results of patients with syndesmotic screw fixation: implications for screw removal. J Orthop Trauma 24:2–6

  36. 36.

    Chissell HR, Jones J (1995) The influence of a diastasis screw on the outcome of Weber type‑C ankle fractures. J Bone Joint Surg Br 77(3):435–438

  37. 37.

    Weening B, Bhandari M (2005) Predictors of functional outcome following transsyndesmotic screw fixation of ankle fractures. J Orthop Trauma 19:102–108

Download references

Author information

Correspondence to Dr. Konrad Kamin.

Ethics declarations

Interessenkonflikt

K. Kamin erhielt Vortragshonorare von AOTrauma Deutschland. D. Notov gibt an, dass kein finanzieller Interessenkonflikt besteht. C. Kleber: Vortragshonorar: AOTrauma Deutschland. – Patent: „CD8 T cell subsets (CD3+8 + 11a++28-57+ = CD8+ TEMRA, and CD4+8+ double positive T cells) as a risk marker for predicting delayed or incomplete fracture healing and as a therapeutic target to improve the outcome of bone fracture healing. CH 592“. O. Al-Sadi gibt an, dass kein finanzieller Interessenkonflikt besteht. S. Rammelt: Begutachtete Mittel für Grundlagenforschung durch die Deutsche Forschungsgemeinschaft (DFG). – Reisekosten von AO Trauma für Kurse und Arbeitsgruppensitzungen.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Redaktion

P. Biberthaler, München

T. Gösling, Braunschweig

T. Mittlmeier, Rostock

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kamin, K., Notov, D., Kleber, C. et al. Versorgung der Sprunggelenkfraktur: operative Technik. Unfallchirurg 123, 57–67 (2020). https://doi.org/10.1007/s00113-019-00754-w

Download citation