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Der Unfallchirurg

, Volume 122, Issue 4, pp 309–322 | Cite as

Mittel- und Vorfußfrakturen

  • M. BeckEmail author
  • A. Wichelhaus
  • R. Rotter
  • P. Gierer
  • T. Mittlmeier
CME

Zusammenfassung

Mittelfußknochen- und Zehenfrakturen sind die häufigsten Verletzungen des Fußskeletts. Undislozierte Frakturen können mit gutem Erfolg konservativ behandelt werden. Langfristige Entlastungen und eine das Sprunggelenk einbeziehende Ruhigstellung sind nicht erforderlich. Basisnahe Metatarsalefrakturen sind fast immer mit Lisfranc-Luxationen assoziiert; die Therapie muss die Instabilität der tarsometatarsalen Gelenkreihe mitberücksichtigen. Eine differenzierte Betrachtung erfordern die Basisfrakturen des 5. Mittelfußknochens. Die korrekte Klassifizierung ist notwendig, um eine adäquate Therapie einleiten zu können. Generell werden intraartikuläre Stufenbildungen, Abkippungen >10° und Verkürzungen zwischen 3 mm und 5 mm unter besonderer Berücksichtigung der Position der Metatarsaleköpfchen als Operationsindikation empfohlen. Eine operative Therapie von Zehenfrakturen ist nur selten notwendig.

Schlüsselwörter

Klassifikation Frakturdislokation Konservative Therapie Osteosynthese, Fraktur Evidenzbasierte Medizin 

Metatarsal and toe fractures

Abstract

Metatarsal and toe fractures are the most frequent injuries of the foot skeleton. Nondislocated fractures can be conservatively treated with good success. Long-term relief and immobilization including the ankle joint are unnecessary. Metatarsal fractures close to the base are nearly always associated with Lisfranc luxation and treatment must also take the instability of the tarsometatarsal joints into consideratíon. Basal fractures of the 5th metatarsal bone require a differentiated consideration. The correct classification is necessary in order to initiate an adequate treatment. In general, intra-articular layer formation, inclination >10° and shortening between 3 mm and 5 mm, taking the position of the head of the metatarsal bone into consideration, are recommended as indications for surgery. Operative treatment of toe fractures is only rarely necessary.

Keywords

Classification Fracture dislocation Conservative treatment Osteosynthesis, fracture Evidence-based medicine 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

M. Beck, A. Wichelhaus, R. Rotter, P. Gierer und T. Mittlmeier 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 2019

Authors and Affiliations

  • M. Beck
    • 1
    Email author
  • A. Wichelhaus
    • 2
  • R. Rotter
    • 2
  • P. Gierer
    • 2
  • T. Mittlmeier
    • 2
  1. 1.Klinik für Orthopädie und UnfallchirurgieSt. Bernward KrankenhausHildesheimDeutschland
  2. 2.Abteilung für Unfall‑, Hand- und WiederherstellungschirurgieUniversitätsmedizin RostockRostockDeutschland

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